Provider Demographics
NPI:1356385256
Name:LABOSKY, ANN C (PT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:C
Last Name:LABOSKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:C
Other - Last Name:KUNKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3030 N CIRCLE DR
Mailing Address - Street 2:SUITE 217
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1177
Mailing Address - Country:US
Mailing Address - Phone:719-776-4888
Mailing Address - Fax:
Practice Address - Street 1:3030 N CIRCLE DR
Practice Address - Street 2:SUITE 217
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1177
Practice Address - Country:US
Practice Address - Phone:719-776-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
516358Medicare ID - Type Unspecified