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General NPI Number Information
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NPI Number | 1760502496
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL PHYSICAL THERAPY ASSOCIATES
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3002 S ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80916-3202
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Country | US
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Telephone | 719-390-7010
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Fax | 719-390-8848
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Provider Business Mailing Address
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Address Line | 3002 S ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80916-3202
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Country | US
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Telephone | 719-390-7010
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Fax | 719-390-8848
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MICHAEL MOORE
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Credential |
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Telephone | 719-390-7010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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