Provider Demographics
NPI:1154860112
Name:MELLAND, RITA A (RT(R)(M)(CT) (ARRT)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:MELLAND
Suffix:
Gender:F
Credentials:RT(R)(M)(CT) (ARRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 MEDICAL CENTER PT
Mailing Address - Street 2:SUITE 190
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8731
Mailing Address - Country:US
Mailing Address - Phone:719-955-6000
Mailing Address - Fax:719-955-9595
Practice Address - Street 1:1625 MEDICAL CENTER PT
Practice Address - Street 2:SUITE 190
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8731
Practice Address - Country:US
Practice Address - Phone:719-955-6000
Practice Address - Fax:719-955-9595
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2377352471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography