Organization
US ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE BOUNDS (CREDENTIALS OFFICE)
(719) 526-7732
Entity
Organization
Contact information
Practice address
1650 COCHRANE CIR, FT CARSON, CO 80913-4613
(719) 526-7732
Mailing address
6826 SASSER DR APT A, COLORADO SPRINGS, CO 80902-2194
(704) 651-8164
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
1125466
CO
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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