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General NPI Number Information
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NPI Number | 1932651726
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Entity Type | Individual
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Provider Name | MICHAEL MUSELLA CNIM
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Gender | Male
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 1325 BOWSTRING RD
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City | MONUMENT
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State | CO
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Zip | 80132-8580
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Country | US
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Telephone | 303-981-7464
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Fax |
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Provider Business Mailing Address
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Address Line | 20175 TWISTED PINE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-2352
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number |
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License Number State |
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