Healthcare Provider Details

I. General information

NPI: 1952887051
Provider Name (Legal Business Name): PRIZE PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8145 BIRCH DR
RYE CO
81069-8809
US

IV. Provider business mailing address

8145 BIRCH DR
RYE CO
81069-8809
US

V. Phone/Fax

Practice location:
  • Phone: 612-440-6016
  • Fax:
Mailing address:
  • Phone: 612-440-6016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: KAREN MALONE
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 612-440-6016