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NPI Code Detail

MEDICARE: METAMORPHOSIS LTD

MEDICARE: METAMORPHOSIS LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine Physician
2225100000XPhysical Therapist
3363L00000XNurse Practitioner
4363LF0000XFamily Nurse Practitioner
5367500000XCertified Registered Nurse Anesthetist
6208VP0014XInterventional Pain Medicine Physician

Other Identifiers

General Provider Information

NPI Number : 1003415860
Entity Type Code : Organization
Provider Name (Legal Business Name) : METAMORPHOSIS LTD
Provider Business Mailing Address
First Line : PO BOX 1868
Second Line :
City : CANON CITY
State : CO
Zip : 81215-1868
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6015 LEHMAN DR STE 205
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3421
Country : US
Telephone Number : 719-896-4180
Fax Number : 888-285-7140
Authorized Official
Title or Position : MANAGER
Name : JESSICA HESLEP
Credential :
Telephone Number : 719-852-3420
Provider Enumeration Date : 10/22/2020
Last Update Date : 02/22/2024

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Directions to “METAMORPHOSIS LTD ” Practice Location

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