Organization
CENTURA VENTURES, LLC
Active
Other names
CS CEN PT TRI-LAKES, Centura Physical Therapy at Tri-Lakes, CommonSpirit Physical Therapy Tri-Lakes, Colorado Sport and Spine Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA CARPENTER RN (VP, AMBULATORY SERVICES)
(303) 765-6998
Entity
Organization
Contact information
Practice address
17230 JACKSON CREEK PKWY STE 170, MONUMENT, CO 80132-7303
(719) 571-7080
(719) 571-7089
Mailing address
PO BOX 801172, KANSAS CITY, MO 64180-1172
(800) 953-0104
(303) 765-6670
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073882197
OLD NPI
—
05
—
21500851
—
CO
Enumeration date
02/06/2020
Last updated
11/12/2024
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