Healthcare Provider Details

I. General information

NPI: 1629579909
Provider Name (Legal Business Name): TOTAL HANDYMAN ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4856 LITTLE LONDON DR
COLORADO SPRINGS CO
80923-6293
US

IV. Provider business mailing address

PO BOX 64065
COLORADO SPRINGS CO
80962-4065
US

V. Phone/Fax

Practice location:
  • Phone: 719-212-0078
  • Fax:
Mailing address:
  • Phone: 719-212-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: WESLEY BAUER
Title or Position: OWNER
Credential:
Phone: 719-212-0078