MEDICARE: PATRICK THOMAS GOULD PT, 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	PTL.0021143	CO

General Provider Information

NPI Number	:	1790612208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK THOMAS GOULD PT, DPT

Provider Business Mailing Address
First Line	:	3733 PRECISION DR APT 330
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-4589
Country	:	US
Telephone Number	:	719-360-0512
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 JOHN F KENNEDY PKWY STE 120
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2635
Country	:	US
Telephone Number	:	970-663-6142
Fax Number	:

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

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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