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General NPI Number Information
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NPI Number | 1457665713
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Entity Type | Organization
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Legal Business Name | FRONT RANGE URGENT CARE, INC.
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 5799 STETSON HILLS BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-4222
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Country | US
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Telephone | 719-471-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 5799 STETSON HILLS BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-4223
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Country | US
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Telephone | 719-471-2273
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Fax | 719-380-0228
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Authorized Official
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Title or Position | OWNER
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Name | ANITA WIESCAMP
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Credential |
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Telephone | 719-510-0957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 49109
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 49109
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License Number State | CO
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