MEDICARE: PHYSICAL THERAPY PLUS, INC

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	225100000X	Physical Therapist	2412	CO

General Provider Information

NPI Number	:	1184622409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY PLUS, INC

Provider Business Mailing Address
First Line	:	PO BOX 447
Second Line	:
City	:	LAMAR
State	:	CO
Zip	:	81052-0447
Country	:	US
Telephone Number	:	719-336-4364
Fax Number	:	719-336-4365

Provider Business Practice Location Address
First Line	:	6935 US HIGHWAY 50
Second Line	:
City	:	LAMAR
State	:	CO
Zip	:	81052-9584
Country	:	US
Telephone Number	:	719-336-4364
Fax Number	:	719-336-4365

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KENT MADSEN
Credential	:	P.T.
Telephone Number	:	719-336-4364

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	05/21/2008

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