Organization Active NPI

Manual Edge Physiotherapy LLC

  • Orthopedic Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1962632620
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2373 Issued in CO
Legal business name
MANUAL EDGE PHYSIOTHERAPY LLC
Practice address
6189 Lehman Dr Ste 202
Colorado Springs, CO 80918-5409
Phone
(719) 694-8342
Fax
(719) 694-8347
NPI assigned
Jul 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy D. Bonack, P.T.
Title
Owner
Phone
(719) 694-8342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 2373 CO Primary

Addresses

Primary practice location

6189 Lehman Dr Ste 202
Colorado Springs, CO 80918-5409

Mailing address

6189 Lehman Dr Ste 202
Colorado Springs, CO 80918-5409
Phone (719) 694-8342

National Provider Directory

National Provider Directory

Locations

5265 N Academy Blvd
Ste 1500
Colorado Springs, CO 80918
Phone (719) 531-6513

6189 Lehman Dr
Ste 202
Colorado Springs, CO 80918
Phone (719) 694-8342

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538697600000",
    "number": "1962632620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6189 LEHMAN DR STE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185409",
            "telephone_number": "719-694-8342",
            "fax_number": "719-694-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6189 LEHMAN DR STE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185409",
            "telephone_number": "719-694-8342",
            "fax_number": "719-694-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUAL EDGE PHYSIOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2018-10-05",
        "status": "A",
        "authorized_official_last_name": "BONACK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-694-8342",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "2373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.