Organization
CENTURA HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGHANN KELLIE VANSLAGER PT, DPT (PHYSICAL THERAPIST)
(719) 285-2624
Entity
Organization
Contact information
Practice address
1338 PHAY AVE, CANON CITY, CO 81212-2302
(719) 285-2600
(719) 285-2601
Mailing address
1338 PHAY AVE, CANON CITY, CO 81212-2302
(719) 285-2600
(719) 285-2601
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
11433
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11433
STATE OF COLORADO
CO
Enumeration date
11/19/2012
Last updated
11/19/2012
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