Provider Demographics
NPI:1245368752
Name:PRICE KLOSS, ANGELA DEE (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:DEE
Last Name:PRICE KLOSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:DEE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:213 E CACHE LA POUDRE ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2958
Mailing Address - Country:US
Mailing Address - Phone:719-667-1007
Mailing Address - Fax:
Practice Address - Street 1:213 E CACHE LA POUDRE ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2958
Practice Address - Country:US
Practice Address - Phone:719-667-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC800430Medicare PIN
IA25120OtherBLUE CROSS BLUE SHIELD