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General NPI Number Information
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NPI Number | 1346228582
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Entity Type | Individual
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Provider Name | TERESA (TERRY) STRUCK MD
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Gender | Female
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 1633 MEDICAL CENTER POINT SUITE 123
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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 | 719-577-9090
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Fax | 719-577-4549
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Provider Business Mailing Address
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Address Line | 1633 MEDICAL CENTER PT, STE 123
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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 | 719-577-9090
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Fax | 719-577-4549
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 27509
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License Number State | CO
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