Individual
MR. JOHN M. MODELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
7500 COCHRANE CIRCLE, ATTN: COL MODELL USA MEDDAC, FORT CARSON, CO 80913
(719) 526-7129
Mailing address
1745 GUMTREE CT, COLORADO SPRINGS, CO 80906-7761
(719) 579-0315
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
332458
CA
Other
Enumeration date
02/16/2006
Last updated
07/08/2007
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