Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 34314 | CO |
NPI | 1134245319 |
---|---|
Provider Name | Rosemary A Greenslade |
First Address | Colorado Springs, CO 80906-1042 |
Second Address | Colorado Springs, CO 80906-1042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 11/04/2012 |