MEDICARE: JOSEPH OSBORNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA0012371	CO

General Provider Information

NPI Number	:	1083042964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH OSBORNE

Provider Business Mailing Address
First Line	:	3145 WOODLAND HILLS DR. APARTMENT 822
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918
Country	:	US
Telephone Number	:	719-426-7105
Fax Number	:

Provider Business Practice Location Address
First Line	:	3145 WOODLAND HILLS DR APT 822
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-4670
Country	:	US
Telephone Number	:	719-426-7105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2013
Last Update Date	:	10/31/2013

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Directions to “ JOSEPH OSBORNE ” Practice Location

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