Provider First Line Business Practice Location Address:
1400 E. BOULDER ST.
Provider Second Line Business Practice Location Address:
MEMORIAL HOSPITAL NORTH
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-365-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2007