MEDICARE: CHRISTOPHER KING BALL DPT

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	19758	CO
2	225100000X	Physical Therapist	16140	NC

General Provider Information

NPI Number	:	1720447576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER KING BALL DPT

Provider Business Mailing Address
First Line	:	6160 TUTT BLVD STE 240
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3502
Country	:	US
Telephone Number	:	719-596-0880
Fax Number	:	719-596-0899

Provider Business Practice Location Address
First Line	:	6160 TUTT BLVD STE 240
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3502
Country	:	US
Telephone Number	:	719-596-0880
Fax Number	:	719-596-0899

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

Provider Enumeration Date	:	02/22/2016
Last Update Date	:	03/28/2024

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