Healthcare Provider Details

I. General information

NPI: 1881993384
Provider Name (Legal Business Name): PAULA MCBRIDE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 S DAYTON ST STE 3800
GREENWOOD VILLAGE CO
80111
US

IV. Provider business mailing address

14725 BLACK FOREST RD
COLORADO SPRINGS CO
80908-2864
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-9007
  • Fax: 855-283-4752
Mailing address:
  • Phone: 719-233-8651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number3499
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number3499
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number3499
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: