Organization
OPTUMCARE COLORADO ASC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G. LIETHEN (SECRETARY)
(952) 205-6262
Entity
Organization
Contact information
Practice address
715 N WEBER ST, COLORADO SPRINGS, CO 80903-1091
(719) 473-6115
Mailing address
2 S CASCADE AVE STE 140, COLORADO SPRINGS, CO 80903-1604
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2017
Last updated
08/19/2019
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