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NPI Code Detail

MEDICARE: MR. RICHARD CHAD ANSELL DPT

MEDICARE: MR. RICHARD CHAD ANSELL DPT
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 Therapist7503CO

General Provider Information

NPI Number : 1174634935
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD CHAD ANSELL DPT
Provider Business Mailing Address
First Line : 6160 TUTT BLVD STE 240
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-3502
Country : US
Telephone Number : 719-596-0880
Fax Number : 719-596-0899
Provider Business Practice Location Address
First Line : 6140 TUTT BLVD
Second Line : SUITE 210
City : COLORADO SPRINGS
State : CO
Zip : 80922-3576
Country : US
Telephone Number : 719-596-0880
Fax Number : 719-596-0899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 09/11/2019

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