| Organization Name: | SPRINGBOK HEALTH INC |
| NPI Number: | 1659751501 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK JANKELOW (OWNER) |
| Mailing Address: | 63 E Spaulding Ave Suite E114 Pueblo West |
| State: | CO US |
| Postal Code: | 810075416 |
| Phone Number: | 7192516877 |
| Fax Number: | 7196471728 |
| NPI Enumeration Date: | 06/05/2015 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |