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General NPI Number Information
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NPI Number | 1679730287
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Entity Type | Organization
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Legal Business Name | PARKMOOR REHABILITATION LLC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 3220 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-5189
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Country | US
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Telephone | 719-636-1616
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26051
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City | COLORADO SPRINGS
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State | CO
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Zip | 80936-6051
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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 | OWNER
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Name | DR. GREGORY CONNER
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Credential | D.C.
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Telephone | 719-636-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 3113
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License Number State | CO
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