Provider Demographics
NPI:1548577810
Name:ABUNDANT HEALTH AND REHAB, PLLC
Entity Type:Organization
Organization Name:ABUNDANT HEALTH AND REHAB, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-630-0254
Mailing Address - Street 1:3425 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5701
Mailing Address - Country:US
Mailing Address - Phone:719-630-0254
Mailing Address - Fax:719-630-0256
Practice Address - Street 1:3425 AUSTIN BLUFFS PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5701
Practice Address - Country:US
Practice Address - Phone:719-630-0254
Practice Address - Fax:719-630-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty