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NPI Code Detail

MEDICARE: SAVANNA GOLSON PT

MEDICARE: SAVANNA GOLSON 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
1225100000XPhysical Therapist0016566CO

General Provider Information

NPI Number : 1598312621
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNA GOLSON PT
Provider Business Mailing Address
First Line : 202 BEAVER CT APT 11
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80905-2057
Country : US
Telephone Number : 281-608-4514
Fax Number :
Provider Business Practice Location Address
First Line : 901 N SANTA FE AVE
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1738
Country : US
Telephone Number : 719-822-0550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2019
Last Update Date : 08/22/2019

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