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NPI Code Detail

MEDICARE: FREEDOM PHYSICAL THERAPY AND WELLNESS LLC

MEDICARE: FREEDOM PHYSICAL THERAPY AND WELLNESS LLC
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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1124791462
Entity Type Code : Organization
Provider Name (Legal Business Name) : FREEDOM PHYSICAL THERAPY AND WELLNESS LLC
Provider Business Mailing Address
First Line : 6445 COOLWELL DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80908-3324
Country : US
Telephone Number : 702-271-1299
Fax Number :
Provider Business Practice Location Address
First Line : 6445 COOLWELL DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80908-3324
Country : US
Telephone Number : 702-271-1299
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANDREW FOX
Credential : DPT
Telephone Number : 719-271-1299
Provider Enumeration Date : 07/30/2021
Last Update Date : 07/30/2021

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Directions to “FREEDOM PHYSICAL THERAPY AND WELLNESS LLC ” Practice Location

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