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General NPI Number Information
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NPI Number | 1801514476
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Entity Type | Organization
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Legal Business Name | BURDICK MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 7680 GODDARD ST STE 214
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-8233
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Country | US
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Telephone | 719-800-1098
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Fax | 719-372-8307
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Provider Business Mailing Address
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Address Line | 7661 MCLAUGHLIN RD # 271
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City | FALCON
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State | CO
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Zip | 80831-4727
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Country | US
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Telephone | 719-800-1098
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Fax | 833-955-3597
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Authorized Official
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Title or Position | OWNER
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Name | GINIA BURDICK
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Credential | NP-C
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Telephone | 719-359-1075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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