Provider First Line Business Practice Location Address:
2222 N NEVADA AVE
Provider Second Line Business Practice Location Address:
PENROSE HOSPITAL, HEREDITARY CANCER SERVICE
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80907-6819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-776-6162
Provider Business Practice Location Address Fax Number:
719-776-6756
Provider Enumeration Date:
05/11/2007