Healthcare Provider Details

I. General information

NPI: 1649796897
Provider Name (Legal Business Name): KATIE LYNN CIRA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 FORTINO BLVD
PUEBLO CO
81008-1856
US

IV. Provider business mailing address

2855 INTERNATIONAL CIR
COLORADO SPRINGS CO
80910-3144
US

V. Phone/Fax

Practice location:
  • Phone: 719-600-5525
  • Fax: 719-375-1276
Mailing address:
  • Phone: 719-447-8822
  • Fax: 719-447-8832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0015146
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: