Penrose Family Health Clinic

NPI #1578910790 in Penrose, Colorado

Provider Information

NPI Number: 1578910790
Entity Type: Organization
Organization Name: Penrose Family Health Clinic
Primary Specialty: Family Medicine
Enumeration Date: May 17, 2016
Last Updated: May 17, 2016

Practice Location

Address: 91 ILLINOIS ST
City: Penrose
State: Colorado
ZIP Code: 81240-9683
Phone: (719) 372-6555

Authorized Official

Name: MADELEINE JACOBS, M.D.
Title: SOLE PROPRIETOR
Phone: (719) 372-6555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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