MEDICARE: DR. NATHAN E. HENRY PT, DPT, CSCS

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	2251S0007X	Sports Physical Therapist	PTL.0011069	CO
2	225100000X	Physical Therapist	PTL.0011069	CO

General Provider Information

NPI Number	:	1114223815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN E. HENRY PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	PO BOX 21150
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80308-4150
Country	:	US
Telephone Number	:	720-316-9974
Fax Number	:	720-294-0332

Provider Business Practice Location Address
First Line	:	5643 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-3658
Country	:	US
Telephone Number	:	720-316-9974
Fax Number	:	720-294-0332

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

Provider Enumeration Date	:	01/28/2011
Last Update Date	:	11/03/2023

Similar Medicare Providers

1467613158 — DR. ADAM LEE KILKENNEY D.O.
Practice Location Address:

5625 N ACADEMY BLVD STE 1800
COLORADO SPRINGS, CO
80918-3658

Practice Phone: 719-599-0444
Practice Fax: 719-599-8809

1093354938 — ANDREW SHORT DPT
Practice Location Address:

5643 N ACADEMY BLVD
COLORADO SPRINGS, CO
80918-3658

Practice Phone: 720-316-9974
Practice Fax: 720-294-0332

1114759743 — JACK EDWARD BUTLER
Practice Location Address:

5643 N ACADEMY BLVD
COLORADO SPGS, CO
80918-3658

Practice Phone: 720-316-9974
Practice Fax:

1962376707 — KARISSA RUTH DEPTULA PT, DPT
Practice Location Address:

5643 N ACADEMY BLVD
COLORADO SPRINGS, CO
80918-3658

Practice Phone: 720-316-9974
Practice Fax: 720-294-0332

1821090705 — DR. ALAN N RUCKET M.D.
Practice Location Address:

1005 IVY FALLS DR
SANDY SPRINGS, GA
30328-3658

Practice Phone: 404-255-1005
Practice Fax: 404-255-1184

1558324624 — MEDICAL PARK PHARMACY LLC
Practice Location Address:

121 E VAN BUREN STE C
EUREKA SPRINGS, AR
72632-3658

Practice Phone: 479-253-9751
Practice Fax: 479-253-7149

Directions to “ DR. NATHAN E. HENRY PT, DPT, CSCS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.