Provider Demographics
NPI:1972109759
Name:JOINT EFFORT PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:JOINT EFFORT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-533-1318
Mailing Address - Street 1:2835 DUBLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1662
Mailing Address - Country:US
Mailing Address - Phone:719-533-1318
Mailing Address - Fax:719-533-1319
Practice Address - Street 1:202 E CHEYENNE MOUNTAIN BLVD STE N
Practice Address - Street 2:
Practice Address - City:COLORADO SPGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3769
Practice Address - Country:US
Practice Address - Phone:719-527-9331
Practice Address - Fax:719-527-9372
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOINT EFFORT PHYSICAL THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000176625Medicaid