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Organization
IDEAL FAMILY HEALTHCARE PC
Active
Organization
IDEAL FAMILY HEALTHCARE PC
Active
Other names
Cottonwood Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY EVAN SHARP MD (PRESIDENT)
(719) 686-8844
Entity
Organization
Contact information
Practice address
335 MANITOU AVE, MANITOU SPRINGS, CO 80829
(719) 686-8844
(719) 686-7449
Mailing address
335 MANITOU AVE, MANITOU SPRINGS, CO 80829-2537
(719) 686-8844
(719) 686-7449
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD3684
PALMETTO GBA
—
Enumeration date
01/14/2008
Last updated
10/15/2018
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