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Organization

EVANS ARMY COMMUNITY HOSPITAL

Active
Parent organization
TERRI WISNIEWSKI
Other names
N/A
Organization subpart
Yes

Provider details

NPI number
Legal business name
TERRI WISNIEWSKI
Authorized official
DR. MARY DEIGHTON DO (PRIMARY CARE MANAGER)
(719) 526-9277
Entity
Organization

Contact information

Practice address
2400 CODY DR, COLORADO SPRINGS, CO 80911-1018
(719) 392-0737
Mailing address
2400 CODY DR, COLORADO SPRINGS, CO 80911-1018
(719) 392-0737

Taxonomy

Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
286500000X
CO

Other

Enumeration date
12/01/2011
Last updated
12/01/2011
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