Healthcare Provider Details

I. General information

NPI: 1295006138
Provider Name (Legal Business Name): JOY M D'ANGELO RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 01/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 GATEHOUSE CIR N #204
COLORADO SPRINGS CO
80904-4961
US

IV. Provider business mailing address

1645 GATEHOUSE CIR N #204
COLORADO SPRINGS CO
80904-4961
US

V. Phone/Fax

Practice location:
  • Phone: 171-942-5654
  • Fax:
Mailing address:
  • Phone: 171-942-5654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number3195
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: