Provider Demographics
NPI:1407456304
Name:COLUMNA, PATRICIA P
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:P
Last Name:COLUMNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICAIA
Other - Middle Name:LOUISE
Other - Last Name:COLUMNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1657 S WHEELING CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5358
Mailing Address - Country:US
Mailing Address - Phone:720-854-4450
Mailing Address - Fax:
Practice Address - Street 1:2522 W SAINT VRAIN ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-2517
Practice Address - Country:US
Practice Address - Phone:303-719-2273
Practice Address - Fax:888-505-3617
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist