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General NPI Number Information
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NPI Number | 1639857337
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Entity Type | Individual
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Provider Name | KARI GREATHOUSE LMT
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Gender | Female
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 3920 N UNION BLVD STE 160
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4907
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Country | US
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Telephone | 512-586-0392
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Fax |
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Provider Business Mailing Address
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Address Line | 1718 POPLAR AVE
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City | CANON CITY
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State | CO
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Zip | 81212-5138
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Country | US
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Telephone | 401-524-1482
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | 0025273
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License Number State | CO
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