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General NPI Number Information
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NPI Number | 1174487409
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Entity Type | Organization
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Legal Business Name | THE WELLSPRING
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 110 S 7TH ST UNIT B
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City | HOTCHKISS
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State | CO
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Zip | 81419-0481
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Country | US
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Telephone | 970-872-9355
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 508
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City | HOTCHKISS
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State | CO
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Zip | 81419-0508
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Country | US
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Telephone | 970-872-9355
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Fax |
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Authorized Official
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Title or Position | MST
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Name | ELISABETH EVANS
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Credential |
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Telephone | 970-773-4728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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