Healthcare Provider Details

I. General information

NPI: 1386599348
Provider Name (Legal Business Name): JOHN MASSEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 ELKTON DR STE 120
COLORADO SPRINGS CO
80907-3516
US

IV. Provider business mailing address

3175 SAPPORO PL
COLORADO SPRINGS CO
80918-1766
US

V. Phone/Fax

Practice location:
  • Phone: 323-794-7366
  • Fax:
Mailing address:
  • Phone: 323-794-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: