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General NPI Number Information
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NPI Number | 1538574041
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Entity Type | Organization
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Legal Business Name | CARC ENTERPRISES INCORPORATED
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1050 S ACADEMY BLVD SUITE 140
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3924
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Country | US
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Telephone | 719-641-9416
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Fax |
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Provider Business Mailing Address
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Address Line | 628 BURKE HOLLOW DR
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City | MONUMENT
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State | CO
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Zip | 80132-6098
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Country | US
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Telephone | 719-337-1643
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORINA OSTOS ARCARESE
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Credential |
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Telephone | 719-337-1643
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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 |
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License Number State |
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