Organization
SUMMIT PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE DENNIS (VICE PRESIDENT)
(193) 008-4337
Entity
Organization
Contact information
Practice address
1120 MINNEQUA AVE, PUEBLO, CO 81004-3734
(719) 281-3285
Mailing address
PO BOX 5300, COLORADO SPRINGS, CO 80931-5300
(303) 253-0896
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/03/2020
Last updated
10/01/2020
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