Organization
INTERMOUNTAIN REHAB ASSOC IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY O. HALL M.D. (PRESIDENT)
(719) 471-0727
Entity
Organization
Contact information
Practice address
559 E PIKES PEAK AVE #100, COLORADO SPRINGS, CO 80903-3657
(719) 471-0727
(719) 471-2116
Mailing address
559 E. PIKES PEAK AVE #100, COLORADO SPRINGS, CO 80903-3657
(719) 471-0727
(719) 471-2116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29593
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01-295930
—
CO
Enumeration date
08/29/2006
Last updated
12/03/2007
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