Provider First Line Business Practice Location Address:
2375 TELSTAR DRIVE
Provider Second Line Business Practice Location Address:
SUITE 110 PT WORKS PC BRIARGATE CLINIC
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80920-1029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-590-7777
Provider Business Practice Location Address Fax Number:
719-590-7121
Provider Enumeration Date:
11/18/2005