Provider Demographics
NPI:1083173850
Name:MOBILITY THERAPY AND FITNESS
Entity Type:Organization
Organization Name:MOBILITY THERAPY AND FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR/CLINICIAN.
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:719-229-6596
Mailing Address - Street 1:6959 KETCHUM DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-9406
Mailing Address - Country:US
Mailing Address - Phone:719-229-6596
Mailing Address - Fax:719-497-6044
Practice Address - Street 1:6959 KETCHUM DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-9406
Practice Address - Country:US
Practice Address - Phone:719-229-6596
Practice Address - Fax:719-497-6044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy