Provider Demographics
NPI:1881323038
Name:NEW TERRAIN PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:NEW TERRAIN PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SISNEROS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:970-978-6918
Mailing Address - Street 1:3822 WINDSONG CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-3512
Mailing Address - Country:US
Mailing Address - Phone:719-454-8687
Mailing Address - Fax:
Practice Address - Street 1:3822 WINDSONG CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3512
Practice Address - Country:US
Practice Address - Phone:970-978-6918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-05
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty