Village Physical Therapy, P.C.

Physical Therapist in Canon City, CO. Organization (NPI-2).

NPI number1790805000

StatusActive

Last updated in NPPESMay 10, 2010

Details

NPI: 1790805000
Entity type: Organization (NPI-2)
Legal business name: Village Physical Therapy, P.C.
Organization subpart: No
Enumeration date: Mar 30, 2007
Last updated: May 10, 2010

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225100000X	Physical Therapist	1497	CO	Yes

Practice location

109 Latigo Ln
Suite A
Canon City, CO 81212-8112

Phone 719-562-0328 · Fax 719-575-0872

Mailing address

545 E Pikes Peak Ave
Suite 320
Colorado Springs, CO 80903-3637

Phone 719-577-4104 · Fax 719-575-0872

Authorized official

Michele Childs
Owner-President
7195774104

Is something wrong?

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Other Physical Therapist providers in Canon City, CO

All 18 Physical Therapist providers in Canon City · All 907 providers in Canon City

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