Provider Demographics
NPI:1790453728
Name:NORTHWAY, JOSHUA SCOTT (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:SCOTT
Last Name:NORTHWAY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6630
Mailing Address - Country:US
Mailing Address - Phone:719-265-6601
Mailing Address - Fax:719-265-6649
Practice Address - Street 1:3605 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6630
Practice Address - Country:US
Practice Address - Phone:719-265-6601
Practice Address - Fax:719-265-6649
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015415225100000X
COCP018446T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist