MEDICARE: BRITTANY RAINBOW PT

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	16267	NC
2	225100000X	Physical Therapist	30612	FL

General Provider Information

NPI Number	:	1528418183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY RAINBOW PT

Provider Business Mailing Address
First Line	:	565 SPACE CENTER DR STE 130
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-3610
Country	:	US
Telephone Number	:	719-638-5054
Fax Number	:

Provider Business Practice Location Address
First Line	:	565 SPACE CENTER DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-3609
Country	:	US
Telephone Number	:	719-638-5054
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	05/07/2025

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