Vail Clinic INC
Clinic/Center in Eagle, CO. Organization (NPI-2).
NPI number1164077897
StatusActive
Last updated in NPPESJan 9, 2025
Details
- NPI
- 1164077897
- Entity type
- Organization (NPI-2)
- Legal business name
- Vail Clinic INC
- Organization subpart
- Yes
- Enumeration date
- Aug 8, 2019
- Certification date
- Jan 9, 2025
- Last updated
- Jan 9, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 261QP2000X | Clinic/Center, Physical Therapy | – | – | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Howard Head Sports Medicine At Eagle (Doing Business As)
Practice location
377 Sylvan Lake Rd Ste 100Eagle, CO 81631-6779
Phone 970-328-6715
Mailing address
Po Box 840220Kansas City, MO 64184-0220
Phone 970-777-2850
Authorized official
Michael G Brown
Svp & Cfo
9704797272
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