Individual
MR. STANLEY HENRY PODOLSKI IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 364-6487
(719) 364-6488
Mailing address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 364-6487
(719) 364-6488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0004454
CO
Other
Enumeration date
10/07/2015
Last updated
05/11/2016
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