Healthcare Provider Details

I. General information

NPI: 1518981158
Provider Name (Legal Business Name): SPECTRUM MOBILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 PALMER PARK BLVD STE 101C
COLORADO SPRINGS CO
80909-3433
US

IV. Provider business mailing address

4020 PALMER PARK BLVD STE 101C
COLORADO SPRINGS CO
80909-3433
US

V. Phone/Fax

Practice location:
  • Phone: 719-574-5234
  • Fax: 719-574-8277
Mailing address:
  • Phone: 719-574-5234
  • Fax: 719-574-8277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number332B00000X
License Number StateCO

VIII. Authorized Official

Name: AARON KNUTSON
Title or Position: DIRECTOR
Credential:
Phone: 719-432-6719