Individual
DR. MELISSA ANNE TADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPTOMETRIST
Contact information
Practice address
6071 E WOODMEN RD, SUITE 205, COLORADO SPRINGS, CO 80923-2607
(719) 380-6808
(719) 380-5656
Mailing address
1865 ANASAZI CT, COLORADO SPRINGS, CO 80919-3487
(719) 380-6808
(719) 380-5656
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2048
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01330357
—
CO
01
—
809893
MEDICARE PTAN
CO
Enumeration date
04/14/2006
Last updated
07/11/2011
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