Individual
MARK ANDREIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2271 SURREY LN, CANON CITY, CO 81212-2565
(719) 276-0638
Mailing address
2271 SURREY LN, CANON CITY, CO 81212-2565
(719) 276-0638
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
180990
CO
Other
Enumeration date
12/26/2014
Last updated
12/26/2014
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