Provider Demographics
NPI:1881993384
Name:MCBRIDE, PAULA (PT)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14725 BLACK FOREST RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2864
Mailing Address - Country:US
Mailing Address - Phone:719-233-8651
Mailing Address - Fax:
Practice Address - Street 1:6535 S DAYTON ST STE 3800
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-649-9007
Practice Address - Fax:855-283-4752
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34992251G0304X, 261QP2000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy