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NPI Code Detail

MEDICARE: OSTEOPATHIC TREATMENT CENTER P C

MEDICARE: OSTEOPATHIC TREATMENT CENTER P C
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
1208D00000XGeneral Practice Physician30332CO
2208100000XPhysical Medicine & Rehabilitation Physician30332CO

General Provider Information

NPI Number : 1487636247
Entity Type Code : Organization
Provider Name (Legal Business Name) : OSTEOPATHIC TREATMENT CENTER P C
Provider Business Mailing Address
First Line : 697 1675 RD
Second Line :
City : DELTA
State : CO
Zip : 81416-3462
Country : US
Telephone Number : 970-874-9595
Fax Number : 970-240-8823
Provider Business Practice Location Address
First Line : 697 1675 RD
Second Line :
City : DELTA
State : CO
Zip : 81416-3462
Country : US
Telephone Number : 970-874-9595
Fax Number : 970-240-8823
Authorized Official
Title or Position : OFFICE MANAGER
Name : MICHELLE JENKINS
Credential :
Telephone Number : 970-240-8822
Provider Enumeration Date : 11/17/2005
Last Update Date : 10/04/2013

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Directions to “OSTEOPATHIC TREATMENT CENTER P C ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.