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General NPI Number Information
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NPI Number | 1588314322
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Entity Type | Organization
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Legal Business Name | COUNTY OF CUSTER
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 205 S 6TH ST
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City | WESTCLIFFE
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State | CO
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Zip | 81252-9504
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Country | US
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Telephone | 719-783-2371
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Fax | 719-783-0163
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Provider Business Mailing Address
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Address Line | PO BOX 929
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City | WESTCLIFFE
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State | CO
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Zip | 81252-0929
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Country | US
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Telephone | 719-783-2371
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Fax | 719-783-0163
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Authorized Official
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Title or Position | IM TECHNICIAN
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Name | RONDA SUE POST
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Credential |
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Telephone | 719-783-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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