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General NPI Number Information
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NPI Number | 1124007596
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Entity Type | Individual
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Provider Name | PATRICK J GALASKA II PA-C, MPAS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 1633 MEDICAL CENTER PT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-5700
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Country | US
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Telephone | 719-228-0400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 719-463-5600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0001062
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License Number State | CO
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