Organization
MOUNTAIN CRC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET S PETERSON (BILLING MANAGER)
(719) 676-7060
Entity
Organization
Contact information
Practice address
1240 DANCING HORSE DR, COLORADO SPRINGS, CO 80919-3910
(719) 676-7060
(719) 676-7808
Mailing address
5691 HOUSMAN AVE, PUEBLO, CO 81004-9709
(719) 676-7060
(719) 676-7808
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
123859
CO
Other
Enumeration date
08/22/2006
Last updated
08/22/2020
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