Organization
SELECT REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLA S GRZEGORCZYK MA, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(719) 551-6499
Entity
Organization
Contact information
Practice address
2365 PATRIOT HTS, COLORADO SPRINGS, CO 80904-5122
(719) 551-6499
Mailing address
4835 TETON PL, COLORADO SPRINGS, CO 80918-5234
(719) 551-6499
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001273
MANAGED CARE
CO
Enumeration date
11/22/2022
Last updated
11/22/2022
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