Healthcare Provider Details

I. General information

NPI: 1942215447
Provider Name (Legal Business Name): MELODIE R COLYAR OTR,CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 RESEARCH PKWY SUITE 225
COLORADO SPRINGS CO
80920-1070
US

IV. Provider business mailing address

2435 RESEARCH PKWY SUITE 225
COLORADO SPRINGS CO
80920-1070
US

V. Phone/Fax

Practice location:
  • Phone: 719-260-2400
  • Fax: 719-260-8405
Mailing address:
  • Phone: 719-260-8400
  • Fax: 719-260-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number1541
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: