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General NPI Number Information
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NPI Number | 1942540851
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Entity Type | Organization
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Legal Business Name | THE ORTHOPAEDIC AND SPINE CENTER OF SOUTHERN COLORADO, LLC
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Dates
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Enumeration Date | 03/01/2013
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 4110 BRIARGATE PKWY SUITE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7835
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Country | US
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Telephone | 720-287-5362
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Fax |
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Provider Business Mailing Address
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Address Line | 1658 COLE BLVD STE 100
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City | LAKEWOOD
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State | CO
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Zip | 80401-3304
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Country | US
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Telephone | 720-287-5362
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | LISA AUSTIN
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Credential |
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Telephone | 720-287-5362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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