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General NPI Number Information
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NPI Number | 1912136474
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Entity Type | Organization
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Legal Business Name | LIFEHOUSE MEDICINE, PLLC
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 422 D ST
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City | SALIDA
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State | CO
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Zip | 81201-2845
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Country | US
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Telephone | 719-221-2292
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 421
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City | SALIDA
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State | CO
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Zip | 81201-0421
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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/MANAGER
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Name | DR. D REED SATHER
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Credential | M.D.
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Telephone | 719-221-2292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 42184
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 42184
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License Number State | CO
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