Provider Demographics
NPI:1306050364
Name:RUBICON PHYSICAL THERAPY
Entity type:Organization
Organization Name:RUBICON PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:MUZZIO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT,MTC,ACSM
Authorized Official - Phone:719-471-8142
Mailing Address - Street 1:559 E PIKES PEAK AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3651
Mailing Address - Country:US
Mailing Address - Phone:719-471-8142
Mailing Address - Fax:719-471-2116
Practice Address - Street 1:559 E PIKES PEAK AVE
Practice Address - Street 2:STE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3651
Practice Address - Country:US
Practice Address - Phone:719-471-8142
Practice Address - Fax:719-471-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7313174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO65781783Medicaid
CO65781783Medicaid