Healthcare Provider Details

I. General information

NPI: 1962578740
Provider Name (Legal Business Name): INVIVO, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 N UNION BLVD
COLORADO SPRINGS CO
80909-1107
US

IV. Provider business mailing address

2415 N UNION BLVD
COLORADO SPRINGS CO
80909-1107
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-4275
  • Fax: 719-471-0760
Mailing address:
  • Phone: 719-632-4275
  • Fax: 719-471-0760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOHN MISHASEK
Title or Position: PRESIDENT
Credential: CPED
Phone: 719-632-4275