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General NPI Number Information
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NPI Number | 1346273521
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Entity Type | Organization
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Legal Business Name | PIKES PEAK ALLERGY & ASTHMA
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 595 CHAPEL HILLS DR 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1024
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Country | US
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Telephone | 719-578-0909
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Fax | 719-260-7790
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Provider Business Mailing Address
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Address Line | 1710 JET STREAM DR STE 105
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-3937
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Country | US
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Telephone | 719-260-1022
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Fax | 719-260-7790
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Authorized Official
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Title or Position | OWNER / PHYSICIAN
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Name | DR. NATHANAEL STEVEN BRADY
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Credential | D.O.
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Telephone | 719-260-1022
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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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