Provider Demographics
NPI:1407209026
Name:INNOVATE PHYSICAL THERAPY, LLC.
Entity Type:Organization
Organization Name:INNOVATE PHYSICAL THERAPY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MS, MTC
Authorized Official - Phone:719-337-1748
Mailing Address - Street 1:1935 JAMBOREE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-5456
Mailing Address - Country:US
Mailing Address - Phone:719-260-1493
Mailing Address - Fax:719-260-1494
Practice Address - Street 1:1935 JAMBOREE DR STE 202
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-5456
Practice Address - Country:US
Practice Address - Phone:719-260-1493
Practice Address - Fax:719-260-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty