| |
1625 Medical Center Pt Ste 210, Colorado Springs, CO 80907-5798 | |
(719) 635-5803 | |
(719) 448-0164 |
Full Name | |
---|---|
Type | Facility |
Speciality | Internal Medicine - Sleep Medicine |
Location | 1625 Medical Center Pt Ste 210, Colorado Springs, Colorado |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770714339 | NPI | - | NPPES |
06085288 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (Colorado) | Secondary |
207RS0012X | Internal Medicine - Sleep Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 35380, Las Vegas, NV 89133-5380 Ph: (702) 579-3203 | 1625 Medical Center Pt Ste 210, Colorado Springs, CO 80907-5798 Ph: (719) 635-5803 |