MEDICARE: LAUREN ARCENEAUX BORYLA

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
2	225100000X	Physical Therapist	3708	NE
3	225100000X	Physical Therapist	0014311	CO

General Provider Information

NPI Number	:	1376992701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ARCENEAUX BORYLA

Provider Business Mailing Address
First Line	:	2375 TELSTAR DR STE 160
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1043
Country	:	US
Telephone Number	:	719-305-8202
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 TELSTAR DR STE 160
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1043
Country	:	US
Telephone Number	:	719-305-8202
Fax Number	:

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

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	06/05/2023

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Directions to “ LAUREN ARCENEAUX BORYLA ” Practice Location

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