MARILLAC CLINIC INC. NPI 1518239219

NPI Information

MARILLAC CLINIC, INC. is a federally qualified health center (fqhc) clinic center in Grand Junction, CO. MARILLAC CLINIC, INC. NPI is 1518239219. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2333 N 6TH ST
GRAND JUNCTION, CO
ZIP 81501
Phone: (970) 298-1782
Fax: (970) 298-6314

The provider's authorized official is Lata Ramachandran .
The authorized official title is Executive Director and has the following contact phone number (970) 298-2235.

The enumeration date for this NPI number is 1/27/2012 and was last updated on 9/21/2020.

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:

Other Identifiers

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