Medevals Of Colorado, INC.
General Practice in Colorado Springs, CO. Organization (NPI-2).
NPI number1982102406
StatusActive
Last updated in NPPESJan 28, 2021
Details
- NPI
- 1982102406
- Entity type
- Organization (NPI-2)
- Legal business name
- Medevals Of Colorado, INC.
- Organization subpart
- No
- Enumeration date
- Jan 30, 2018
- Certification date
- Jan 28, 2021
- Last updated
- Jan 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
1233 Lake Plaza Dr Ste BColorado Springs, CO 80906-3567
Phone 949-510-2810
Mailing address
536 Bluebird Canyon DrLaguna Beach, CA 92651-3307
Authorized official
Steven A Nahm
President
9495102810
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