Healthcare Provider Details

I. General information

NPI: 1275100133
Provider Name (Legal Business Name): FIRST CHOICE SURGICAL ASSISTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

4679 SKYWRITER CIR
COLORADO SPRINGS CO
80922-2151
US

V. Phone/Fax

Practice location:
  • Phone: 307-220-1112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: AMBERLEE MORE
Title or Position: CSFA
Credential:
Phone: 307-220-1112