Provider Demographics
NPI:1922986793
Name:COLON, LUIS
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:COLON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11681 VOYAGER PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3864
Mailing Address - Country:US
Mailing Address - Phone:719-344-9342
Mailing Address - Fax:719-375-3531
Practice Address - Street 1:11681 VOYAGER PKWY STE 150
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3864
Practice Address - Country:US
Practice Address - Phone:719-344-9342
Practice Address - Fax:719-375-3531
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0009010225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist