MEDICARE: NATHAN RUBIO 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	0018933	CO

General Provider Information

NPI Number	:	1831895317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN RUBIO DPT

Provider Business Mailing Address
First Line	:	2503 N WAHSATCH AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6926
Country	:	US
Telephone Number	:	719-314-5818
Fax Number	:	719-314-5818

Provider Business Practice Location Address
First Line	:	2503 N WAHSATCH AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6926
Country	:	US
Telephone Number	:	719-314-5818
Fax Number	:	719-314-5818

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

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	06/04/2026

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