| Rivendell Health Pc | |
|
1465 Kelly Johnson Blvd Ste 310 Colorado Springs CO 80920-3947 | |
| (719) 726-6573 | |
| Not Available |
| Full Name | Rivendell Health Pc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1465 Kelly Johnson Blvd Ste 310, Colorado Springs, Colorado |
| Authorized Official Name and Position | Michael R Fry (PRESIDENT) |
| Authorized Official Contact | 7197266573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivendell Health Pc 1465 Kelly Johnson Blvd Ste 310 Colorado Springs CO 80920-3947 Ph: (719) 726-6573 | Rivendell Health Pc 1465 Kelly Johnson Blvd Ste 310 Colorado Springs CO 80920-3947 Ph: (719) 726-6573 |
| NPI Number | 1730927567 |
|---|---|
| Provider Enumeration Date | 07/16/2024 |
| Last Update Date | 07/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730927567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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