Provider Demographics
NPI:1467819144
Name:CARESPAN USA, INC.
Entity Type:Organization
Organization Name:CARESPAN USA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-800-8296
Mailing Address - Street 1:7102 LA VISTA PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-0800
Mailing Address - Country:US
Mailing Address - Phone:303-800-8296
Mailing Address - Fax:303-800-8226
Practice Address - Street 1:7102 LA VISTA PL
Practice Address - Street 2:SUITE 203
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-0800
Practice Address - Country:US
Practice Address - Phone:303-800-8296
Practice Address - Fax:303-800-8226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20151449233261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care