Healthcare Provider Details

I. General information

NPI: 1356615926
Provider Name (Legal Business Name): ERIC J TOLA DPT,PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7622 MCLAUGHLIN RD
PEYTON CO
80831-4710
US

IV. Provider business mailing address

9070 W CHEYENNE AVE STE 100
LAS VEGAS NV
89129-8935
US

V. Phone/Fax

Practice location:
  • Phone: 719-495-3133
  • Fax: 719-495-8685
Mailing address:
  • Phone: 702-268-7213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberMSPTL.0000039
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: