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NPI Code Detail

MEDICARE: JODY MARIE TAFT PT

MEDICARE: JODY MARIE TAFT PT
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
1225100000XPhysical Therapist3735CO

General Provider Information

NPI Number : 1124529060
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODY MARIE TAFT PT
Provider Business Mailing Address
First Line : 6065 BURGESS RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80908-3905
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2365 PATRIOT HTS
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-5122
Country : US
Telephone Number : 719-960-7501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2018
Last Update Date : 02/26/2018

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