Organization
NORTH PLATTE REGIONAL UROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GALLENTINE (UROLOGIST SOLE PROPRIETOR OWNER)
(719) 393-2137
Entity
Organization
Contact information
Practice address
611 W FRANCIS ST, NORTH PLATTE, NE 69101-0620
(719) 393-2137
Mailing address
4455 STONEHAVEN DR, COLORADO SPRINGS, CO 80906-4897
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
20757
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356311583
PERSONAL NPI
—
Enumeration date
01/30/2007
Last updated
08/22/2020
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