Provider Demographics
NPI:1184744716
Name:COLOSKY, PAUL ELVIN JR (PT, ATC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ELVIN
Last Name:COLOSKY
Suffix:JR
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2776 S ARLINGTON MILL DR UNIT 123
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3402
Mailing Address - Country:US
Mailing Address - Phone:703-493-0180
Mailing Address - Fax:832-201-9314
Practice Address - Street 1:3208 7TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-2410
Practice Address - Country:US
Practice Address - Phone:703-493-0180
Practice Address - Fax:832-201-9314
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT872413225100000X
TX1173220225100000X
TXAT25952255A2300X
VA2305212445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer