Doctor Name: | PETER DE JONG |
NPI Number: | 1225108483 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, CFMT, MTC |
License Number: | 6090 |
Business Practice Address: | 502 E Pikes Peak Ave Suite 110 Colorado Springs, CO - 809033611 |
Business Phone Number: | 7194732958 |
Business Fax Number: | 7194731004 |
Mailing Address: | 502 E Pikes Peak Ave, Suite 110 COLORADO SPRINGS |
State: | CO |
Postal Code: | 809033611 |
Phone Number: | 7194732958 |
Fax Number: | 7194731004 |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 05/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6090 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |