Basic Information
| Provider Information | |||||||||
| NPI: | 1750524286 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRIKE | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BLUM | ||||||||
| OtherFirstName: | MELISSA | ||||||||
| OtherMiddleName: | R | ||||||||
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| OtherCredential: | D.O. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2695 ROCKY MOUNTAIN AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805389071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706244034 | ||||||||
| FaxNumber: | 9704904347 | ||||||||
| Practice Location | |||||||||
| Address1: | 5818 N NEVADA AVENUE SU | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193657130 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2009 | ||||||||
| LastUpdateDate: | 01/25/2021 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 2013027444 | MO | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 390200000X | OT012928 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208100000X | DR.0062119 | CO | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.