Provider Demographics
NPI:1124791462
Name:FREEDOM PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:FREEDOM PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:719-271-1299
Mailing Address - Street 1:6445 COOLWELL DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-3324
Mailing Address - Country:US
Mailing Address - Phone:702-271-1299
Mailing Address - Fax:
Practice Address - Street 1:6445 COOLWELL DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-3324
Practice Address - Country:US
Practice Address - Phone:702-271-1299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy