Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 102 E 2nd Ave, Kit Carson, Colorado |
Authorized Official Name and Position | Charlene Korrell (CEO) |
Authorized Official Contact | 7197675662 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 578 Cheyenne Wells CO 80810-0578 Ph: (719) 767-5661 | 102 E 2nd Ave Kit Carson CO 80825 Ph: (719) 962-3501 |
NPI Number | 1265692339 |
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Provider Enumeration Date | 06/12/2008 |
Last Update Date | 11/09/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265692339 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |