Individual
EMAD YASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2855 INTERNATIONAL CIR, COLORADO SPRINGS, CO 80910-3144
(719) 494-1002
(719) 494-1824
Mailing address
9865 EAGLET WAY, COLORADO SPRINGS, CO 80908-4798
(719) 494-1002
(719) 494-1824
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7271
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60638320
—
CO
01
—
7271
STATE LICENSE
CO
01
—
P00411530
RAILROAD MEDICARE
CO
Enumeration date
12/07/2006
Last updated
12/10/2007
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