Individual
MRS. MELISSA ANN VOUTSALATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15854 JACKSON CREEK PKWY, SUITE 120, MONUMENT, CO 80132-8662
(719) 364-9930
(719) 364-9939
Mailing address
15854 JACKSON CREEK PKWY, SUITE 120, MONUMENT, CO 80132-8662
(719) 364-9930
(719) 364-9939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0054354
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10506730
—
CO
Enumeration date
09/03/2008
Last updated
05/04/2021
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