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General NPI Number Information
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NPI Number | 1801322276
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Entity Type | Organization
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Legal Business Name | A. LIDDLE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 405 WINDCHIME PL
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1984
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Country | US
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Telephone | 720-281-0397
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Fax |
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Provider Business Mailing Address
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Address Line | 14602 BLUE WINGS WAY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-4806
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Country | US
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Telephone | 720-281-0397
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Fax |
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Authorized Official
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Title or Position | OWNER- PHYSICAL THERAPIST
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Name | DR. ANGELA MARIE LIDDLE
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Credential | PT DPT OCS
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Telephone | 720-281-0397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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