MEDICARE: TONYA FREEZE ED.S., LAT, ATC

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	2255A2300X	Athletic Trainer	MSAT.0000008	CO

General Provider Information

NPI Number	:	1164903761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA FREEZE ED.S., LAT, ATC

Provider Business Mailing Address
First Line	:	4925 N NEVADA
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918
Country	:	US
Telephone Number	:	253-266-3176
Fax Number	:

Provider Business Practice Location Address
First Line	:	4925 N NEVADA
Second Line	:	SUITE 102
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918
Country	:	US
Telephone Number	:	719-776-7846
Fax Number	:

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

Provider Enumeration Date	:	08/22/2018
Last Update Date	:	03/31/2026

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