Individual
DANIELLE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6208 LEHMAN DRIVE, SUITE 108, COLORADO SPRINGS, CO 80918
(719) 572-6100
Mailing address
220 RUSKIN DRIVE, COLORADO SPRINGS, CO 80910
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
02/28/2014
Last updated
02/28/2014
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