Organization
PPNA ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANINE PITTMAN (AUTHORIZED OFFICIAL)
(719) 955-2651
Entity
Organization
Contact information
Practice address
2002 LELARAY ST, SUITE 100, COLORADO SPRINGS, CO 80909-2804
(719) 799-6401
Mailing address
40 VALLEY STREAM PKWY, SUITE 100, MALVERN, PA 19355-1407
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2017
Last updated
06/25/2019
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