Healthcare Provider Details

I. General information

NPI: 1750524286
Provider Name (Legal Business Name): MELISSA R STRIKE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA R BLUM D.O.

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 01/25/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5818 N NEVADA AVENUE SU SUITE 225
COLORADO SPRINGS CO
80918
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-7130
  • Fax:
Mailing address:
  • Phone: 970-624-4034
  • Fax: 970-490-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2013027444
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberOT012928
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberDR.0062119
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: