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Organization
PROACTIVE PHYSICAL THERAPY LLC
Active
Organization
PROACTIVE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON JANE RECTOR PT (OWNER)
(719) 535-2757
Entity
Organization
Contact information
Practice address
9320 GRAND CORDERA PKWY, SUITE 125, COLORADO SPRINGS, CO 80924-7003
(719) 535-2757
(719) 535-2767
Mailing address
9320 GRAND CORDERA PKWY, SUITE 125, COLORADO SPRINGS, CO 80924-7003
(719) 535-2757
(719) 535-2767
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11278
CO
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
5635
CO
2251X0800X
Orthopedic Physical Therapist
13537
CO
225X00000X
Occupational Therapist
2586
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12134040
—
CO
Enumeration date
06/13/2006
Last updated
06/13/2016
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