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Organization

ABUNDANT HEALTHCARE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KARL LARSEN M.D. (VICE PRESIDENT)
(719) 630-0254
Entity
Organization

Contact information

Practice address
5630 N ACADEMY BLVD, COLORADO SPRINGS, CO 80918-3659
(719) 630-0254
(719) 630-0256
Mailing address
5630 N ACADEMY BLVD, COLORADO SPRINGS, CO 80918-3659
(719) 630-0254
(719) 630-0256

Taxonomy

Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
43404
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
COA106293
GROUP PTAN
CO
Enumeration date
02/04/2011
Last updated
06/08/2012
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