Organization
THE PEAK PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY VAUGHN SANDELL M.D. (OWNER)
(719) 591-5545
Entity
Organization
Contact information
Practice address
2955 PROFESSIONAL PL STE 201, COLORADO SPRINGS, CO 80904-8140
(719) 591-5545
Mailing address
2955 PROFESSIONAL PL STE 201, COLORADO SPRINGS, CO 80904-8140
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
34408
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01344084
—
CO
01
—
1679522254
NPI
CO
Enumeration date
07/09/2015
Last updated
07/09/2015
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