Provider Demographics
NPI:1194190322
Name:SPRINGS INTEGRATED HEALTH PC
Entity Type:Organization
Organization Name:SPRINGS INTEGRATED HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-761-0221
Mailing Address - Street 1:1465 KELLY JOHNSON BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3945
Mailing Address - Country:US
Mailing Address - Phone:719-445-6077
Mailing Address - Fax:719-323-6242
Practice Address - Street 1:1465 KELLY JOHNSON BLVD STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3945
Practice Address - Country:US
Practice Address - Phone:719-445-6077
Practice Address - Fax:719-323-6242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty