MEDICARE: MS. CHERYL ANNE VOLSTAD RPSGT

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
1	246Z00000X	Other Specialist/Technologist	6564	CO

General Provider Information

NPI Number	:	1861712838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHERYL ANNE VOLSTAD RPSGT

Provider Business Mailing Address
First Line	:	3963 YATES ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2212
Country	:	US
Telephone Number	:	720-775-1834
Fax Number	:

Provider Business Practice Location Address
First Line	:	3963 YATES ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2212
Country	:	US
Telephone Number	:	720-775-1834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2010
Last Update Date	:	06/01/2010

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