Provider Demographics
NPI:1164673067
Name:PREMIER OCCUPATIONAL MEDICINE PC
Entity type:Organization
Organization Name:PREMIER OCCUPATIONAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:719-203-3300
Mailing Address - Street 1:8115 VOYAGER PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1562
Mailing Address - Country:US
Mailing Address - Phone:719-203-3300
Mailing Address - Fax:719-203-3303
Practice Address - Street 1:8115 VOYAGER PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1562
Practice Address - Country:US
Practice Address - Phone:719-203-3300
Practice Address - Fax:719-203-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine