Organization
SEAN C ODONNELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN C ODONNELL M.D. (OWNER)
(719) 473-6171
Entity
Organization
Contact information
Practice address
629 N NEVADA AVE, SUITE 110, COLORADO SPRINGS, CO 80903-1040
(719) 473-6171
(719) 473-0740
Mailing address
629 N NEVADA AVE, SUITE110, COLORADO SPRINGS, CO 80903-1040
(719) 473-6171
(719) 473-0740
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
25481
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01254812
—
CO
Enumeration date
01/17/2008
Last updated
02/14/2011
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