Provider Demographics
NPI:1629355375
Name:SCHLOSSINGER, GREGORY LEWIS (ATC, SFA)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:LEWIS
Last Name:SCHLOSSINGER
Suffix:
Gender:M
Credentials:ATC, SFA
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 754
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-0754
Mailing Address - Country:US
Mailing Address - Phone:970-376-5152
Mailing Address - Fax:970-569-3260
Practice Address - Street 1:0278 LONGVIEW AVE
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631
Practice Address - Country:US
Practice Address - Phone:970-376-5152
Practice Address - Fax:970-569-3260
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6322255A2300X
246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer