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NPI Code Detail

MEDICARE: OPTIMUM THERAPY AND WELLNESS, LLC

MEDICARE: OPTIMUM THERAPY AND WELLNESS, LLC
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
1261QP2000XPhysical Therapy Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659836633
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTIMUM THERAPY AND WELLNESS, LLC
Provider Business Mailing Address
First Line : 6349 FARTHING DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-7504
Country : US
Telephone Number : 913-269-6120
Fax Number :
Provider Business Practice Location Address
First Line : 2020 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1567
Country : US
Telephone Number : 913-269-6120
Fax Number : 719-219-2321
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : DR. ERIN MARIE SLIVKA
Credential : DPT
Telephone Number : 913-269-6120
Provider Enumeration Date : 02/05/2019
Last Update Date : 02/05/2019

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Directions to “OPTIMUM THERAPY AND WELLNESS, LLC ” Practice Location

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