Melissa Southard

NPI 1750778627 · on the registry since 2015

Practice

Address: 1401 Phay Ave
Canon City, CO 81212
Phone: (719) 275-8656
Organisation at this address: Shadow Mountain Management
Shadow Mountain Management
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: 224Z00000X
224Z00000X
Also registered as: 224Z00000X
Licence states on file: AZ, CO
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-01-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado