Organization
QUALITY REHAB INC
Active
Other names
Quality Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JASON YISU PARK (CEO)
(719) 550-4613
Entity
Organization
Contact information
Practice address
3604 GALLEY RD STE 201, COLORADO SPRINGS, CO 80909-4301
(719) 638-4548
Mailing address
3604 GALLEY RD STE 201, COLORADO SPGS, CO 80909-4301
(719) 635-4548
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000177586
—
CO
Enumeration date
03/04/2020
Last updated
11/30/2020
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