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General NPI Number Information
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NPI Number | 1184731721
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Entity Type | Organization
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Legal Business Name | COLORADO SPRINGS ALLERGY & ASTHMA CLINIC, PC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 3425 AUSTIN BLUFFS PKWY SUITE 205
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-5701
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Country | US
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Telephone | 719-592-1365
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Fax | 719-592-1370
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Provider Business Mailing Address
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Address Line | 3425 AUSTIN BLUFFS PKWY SUITE 205
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-5701
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Country | US
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Telephone | 719-592-1365
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Fax | 719-592-1370
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARTHA HARRELL
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Credential |
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Telephone | 719-592-1582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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