Basic Information
| Provider Information | |||||||||
| NPI: | 1235480526 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZILE | ||||||||
| FirstName: | BARRY | ||||||||
| MiddleName: | G. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1685 S. 21ST STREET | ||||||||
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| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80904 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 1685 S. 21ST STREET | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193291774 | ||||||||
| FaxNumber: | 7196348061 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2012 | ||||||||
| LastUpdateDate: | 09/26/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 12207 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.