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NPI Code Detail

MEDICARE: RYAN COLE

MEDICARE: RYAN COLE
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
1103TC0700XClinical Psychologist3942CO

General Provider Information

NPI Number : 1629484332
Entity Type Code : Organization
Provider Name (Legal Business Name) : RYAN COLE
Provider Business Mailing Address
First Line : 5265 N ACADEMY BLVD STE 3300
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-4082
Country : US
Telephone Number : 719-357-6471
Fax Number : 719-631-2526
Provider Business Practice Location Address
First Line : 5265 N ACADEMY BLVD STE 3300
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-4082
Country : US
Telephone Number : 719-357-6471
Fax Number : 719-631-2526
Authorized Official
Title or Position : OWNER
Name : RYAN COLE
Credential : PSY.D
Telephone Number : 224-715-2138
Provider Enumeration Date : 07/02/2014
Last Update Date : 07/02/2014

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Directions to “RYAN COLE ” Practice Location

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