Healthcare Provider Details

I. General information

NPI: 1972679793
Provider Name (Legal Business Name): JOESPH'S EXPERTISE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11123 ALLENDALE DR
PEYTON CO
80831-5800
US

IV. Provider business mailing address

PO BOX 76510
COLORADO SPRINGS CO
80970-6510
US

V. Phone/Fax

Practice location:
  • Phone: 719-638-8844
  • Fax: 719-638-8115
Mailing address:
  • Phone: 719-638-8844
  • Fax: 719-638-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOSEPH MARTINEZ
Title or Position: OWNER
Credential:
Phone: 719-573-0315