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General NPI Number Information
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NPI Number | 1962070276
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Entity Type | Organization
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Legal Business Name | SUMMIT INTEGRATED HEALTH PLLC
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 2997 BROADMOOR VALLEY RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4405
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Country | US
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Telephone | 719-445-6077
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Fax |
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Provider Business Mailing Address
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Address Line | 1465 KELLY JOHNSON BLVD STE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3945
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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
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Name | SHANNON DARROW
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Credential |
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Telephone | 404-447-9945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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