Proactive Provider Management, LLC

NPI #1023474152 in Colorado Springs, Colorado

Provider Information

NPI Number: 1023474152
Entity Type: Organization
Organization Name: Proactive Provider Management, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jan 5, 2016
Last Updated: Jan 5, 2016

Practice Location

Address: 9320 GRAND CORDERA PKWY
Address 2: STE 125
City: Colorado Springs
State: Colorado
ZIP Code: 80924-7003
Phone: (719) 535-2757

Authorized Official

Name: MR. SCOTT O'CONNOR
Title: MEMBER
Phone: (805) 266-4154

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Chiropractor	111N00000X
Nutritionist	133N00000X
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Physical Therapist	225100000X	Primary

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