Organization
ROCKY MOUNTAIN TRANSFORMATIONAL RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MATTICE (OWNER)
(719) 505-3467
Entity
Organization
Contact information
Practice address
1716 E YAMPA ST, COLORADO SPRINGS, CO 80909-3855
(719) 505-3467
Mailing address
1716 E YAMPA ST, COLORADO SPRINGS, CO 80909-3855
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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