MEDICARE: ASHLEE NELSON P.T.

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	8830	CO

General Provider Information

NPI Number	:	1598967473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEE NELSON P.T.

Provider Business Mailing Address
First Line	:	8134 POSTROCK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80951-4778
Country	:	US
Telephone Number	:	719-434-2283
Fax Number	:	719-434-2283

Provider Business Practice Location Address
First Line	:	8134 POSTROCK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80951-4778
Country	:	US
Telephone Number	:	719-434-2283
Fax Number	:	719-434-2283

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

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	06/13/2008

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