Individual
DEREK A CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
875 W MORENO AVE, COLORADO SPRINGS, CO 80905-1731
(719) 572-6200
(719) 572-6427
Mailing address
5045 CLIFF POINT CIR E, COLORADO SPRINGS, CO 80919-8108
(719) 260-7939
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
31420
CO
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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