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General NPI Number Information
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NPI Number | 1801116900
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Entity Type | Organization
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Legal Business Name | SLEEP COLORADO INCORPORATED
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 3673 PARKER BLVD SUITE 160C
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City | PUEBLO
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State | CO
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Zip | 81008-2210
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Country | US
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Telephone | 719-696-8113
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Fax | 719-696-8114
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Provider Business Mailing Address
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Address Line | 1849 AUSTIN BLUFFS PKWY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-7843
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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 | CEO
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Name | MIKE THURMAN
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Credential |
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Telephone | 719-291-6543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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