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General NPI Number Information
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NPI Number | 1538534490
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Entity Type | Individual
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Provider Name | LINDSEY KOSS
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Gender | Female
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 1719 E BIJOU ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5736
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Country | US
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Telephone | 719-444-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 6922 MCMAHON ST APT B
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City | COLORADO SPRINGS
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State | CO
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Zip | 80902-7300
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Country | US
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Telephone |
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA0000635
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License Number State | CO
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