Provider Demographics
NPI:1861737967
Name:WESTGATE, JEFF (DPT)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:WESTGATE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 TENDERFOOT HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3920
Mailing Address - Country:US
Mailing Address - Phone:719-527-1840
Mailing Address - Fax:719-576-1352
Practice Address - Street 1:945 TENDERFOOT HILL RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3920
Practice Address - Country:US
Practice Address - Phone:719-527-1840
Practice Address - Fax:719-576-1352
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-01
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist