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NPI Code Detail

MEDICARE: DR. TERESA (TERRY) STRUCK MD

MEDICARE: DR. TERESA (TERRY) STRUCK MD
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
1208100000XPhysical Medicine & Rehabilitation Physician27509CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346228582
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERESA (TERRY) STRUCK MD
Provider Business Mailing Address
First Line : 1633 MEDICAL CENTER PT, STE 123
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-5700
Country : US
Telephone Number : 719-577-9090
Fax Number : 719-577-4549
Provider Business Practice Location Address
First Line : 1633 MEDICAL CENTER POINT
Second Line : SUITE 123
City : COLORADO SPRINGS
State : CO
Zip : 80907-5700
Country : US
Telephone Number : 719-577-9090
Fax Number : 719-577-4549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 10/23/2007

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