Organization
WELLCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM DAN CAMPBELL (OWNER)
(719) 598-5555
Entity
Organization
Contact information
Practice address
2105 ACADEMY CIR, COLORADO SPRINGS, CO 80909-1663
(719) 598-5555
(719) 388-2030
Mailing address
5446 N ACADEMY BLVD STE 105, COLORADO SPRINGS, CO 80918-3668
(719) 598-5555
(719) 388-2030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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