Individual
CHARLES STINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4328 AUSTIN BLUFFS PKWY, COLORADO SPRINGS, CO 80918-2932
(800) 929-4776
Mailing address
9957 GOLF CREST DR, PEYTON, CO 80831-8367
(719) 660-9717
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013111
CO
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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