Sangre De Cristo Family Practice Assoc., P.c.
NPI #1962536326 in Canon City, Colorado
Provider Information
- NPI Number
- 1962536326
- Entity Type
- Organization
- Organization Name
- Sangre De Cristo Family Practice Assoc., P.c.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Mar 15, 2007
- Last Updated
- Jan 5, 2016
Practice Location
- Address
- 712 MACON AVE
- City
- Canon City
- State
- Colorado
- ZIP Code
- 81212-3314
- Phone
- (719) 275-8646
Authorized Official
- Name
- DR. MICHAEL WAYNE BANKER, M.D.
- Title
- PRESIDENT
- Phone
- (719) 275-8646
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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