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General NPI Number Information
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NPI Number | 1407620610
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Entity Type | Organization
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Legal Business Name | SPRINGS SPINE & REHABILITATION LLC
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 1935 DOMINION WAY STE 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1464
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Country | US
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Telephone | 719-623-5648
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Fax | 877-479-7428
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Provider Business Mailing Address
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Address Line | 1935 DOMINION WAY STE 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1464
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Country | US
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Telephone | 719-623-5648
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Fax | 877-479-7428
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ANGEL WILSON
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Credential |
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Telephone | 877-479-7428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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