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General NPI Number Information
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NPI Number | 1396436242
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Entity Type | Organization
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Legal Business Name | C&C CORRECTIONAL HEALTHCARE
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 6577 S FRANKLIN ST
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City | CENTENNIAL
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State | CO
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Zip | 80121-2532
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Country | US
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Telephone | 720-289-1622
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Fax |
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Provider Business Mailing Address
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Address Line | 151 SUMMER ST UNIT 929
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City | MORRISON
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State | CO
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Zip | 80465-3435
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Country | US
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Telephone | 720-289-1622
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Fax |
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Authorized Official
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Title or Position | COO
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Name | KEITH MCDONALD
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Credential |
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Telephone | 720-289-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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