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General NPI Number Information
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NPI Number | 1841841194
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Entity Type | Organization
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Legal Business Name | PIKES PEAK REFLUX AND WEIGHT LOSS SURGERY PLLC
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 6965 TUTT BLVD STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-3598
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Country | US
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Telephone | 719-377-3477
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Fax | 719-988-9705
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Provider Business Mailing Address
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Address Line | PO BOX 3525
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City | MONUMENT
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State | CO
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Zip | 80132-3525
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Country | US
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Telephone | 719-377-3477
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE ANNE UNRUH
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Credential | NP
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Telephone | 719-650-1519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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