BOULDER PLASTIC SURGERY PROF LLC NPI 1134715022

NPI Information

BOULDER PLASTIC SURGERY PROF LLC is a specialist in Longmont, CO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. BOULDER PLASTIC SURGERY PROF LLC NPI is 1134715022. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1950 MOUNTAIN VIEW AVE
LONGMONT, CO
ZIP 80501-129
Phone: (303) 651-5111

The provider's authorized official is Pam Garcia .
The authorized official title is Office Contact and has the following contact phone number (303) 443-2277.

The enumeration date for this NPI number is 12/15/2020 and was last updated on 12/15/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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