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General NPI Number Information
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NPI Number | 1700778040
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Entity Type | Organization
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Legal Business Name | MOUNTAIN MEDICAL FOOT CARE LLC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 5815 DALTRY LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-7805
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Country | US
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Telephone | 719-510-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 5815 DALTRY LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-7805
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Country | US
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Telephone | 719-510-5990
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | KATIE ESHER
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Credential | RN
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Telephone | 719-510-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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