Provider Demographics
NPI:1558517441
Name:PARTANEN, SIMO (PT)
Entity Type:Individual
Prefix:
First Name:SIMO
Middle Name:
Last Name:PARTANEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PRO RODEO DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2334
Mailing Address - Country:US
Mailing Address - Phone:719-592-1788
Mailing Address - Fax:719-592-1790
Practice Address - Street 1:104 PRO RODEO DR
Practice Address - Street 2:SUITE 110
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2334
Practice Address - Country:US
Practice Address - Phone:719-592-1788
Practice Address - Fax:719-592-1790
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPT 10068225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO301414Medicare PIN