Healthcare Provider Details

I. General information

NPI: 1184131161
Provider Name (Legal Business Name): KATHY KARES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 N MEADE AVE
COLORADO SPRINGS CO
80909-3602
US

IV. Provider business mailing address

1228 N MEADE AVE
COLORADO SPRINGS CO
80909-4606
US

V. Phone/Fax

Practice location:
  • Phone: 719-205-1802
  • Fax:
Mailing address:
  • Phone: 719-205-1802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE E DOWDELL
Title or Position: OWNER
Credential:
Phone: 719-205-1802