Individual
MARIIA KOLESNIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA,LMT
Contact information
Practice address
1235 LAKE PLAZA DR STE 221, COLORADO SPRINGS, CO 80906-3556
(719) 271-9663
Mailing address
3923 BERKLEY CT, COLORADO SPRINGS, CO 80906-6371
(302) 864-7067
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0015169
CO
225700000X
Massage Therapist
0026233
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA.0015169
COLORADO DIVISION OF PROFESSIONS AND REGULATIONS
CO
Enumeration date
05/24/2022
Last updated
01/07/2025
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