Provider Demographics
NPI:1326817891
Name:ZINDORF, GREG W
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:W
Last Name:ZINDORF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50005
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80949-0005
Mailing Address - Country:US
Mailing Address - Phone:719-332-0599
Mailing Address - Fax:719-260-0101
Practice Address - Street 1:3910 BUNK HOUSE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-2217
Practice Address - Country:US
Practice Address - Phone:719-332-0599
Practice Address - Fax:719-260-0101
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide