Provider Demographics
NPI:1598193898
Name:HORMONE HEALTH AND WEIGHT LOSS
Entity Type:Organization
Organization Name:HORMONE HEALTH AND WEIGHT LOSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARABIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-530-7030
Mailing Address - Street 1:1465 KELLY JOHNSON BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3955
Mailing Address - Country:US
Mailing Address - Phone:719-530-7030
Mailing Address - Fax:719-530-7042
Practice Address - Street 1:1465 KELLY JOHNSON BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3955
Practice Address - Country:US
Practice Address - Phone:719-530-7030
Practice Address - Fax:719-530-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service