| NPI | 1831531532 |
|---|---|
| Doing Business As | KETAMINE COLORADO SPRINGS |
| Entity Type | Organization |
| Authorized Contact | JANA GAINOK Co Owner 760-780-8702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2021-01-27 |