| 5280 Iom Pro, Llc | |
|
1700 Bassett St Unit 1021 Denver CO 80202-1921 | |
| (346) 221-1597 | |
| (832) 581-4677 |
| Full Name | 5280 Iom Pro, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 1700 Bassett St Unit 1021, Denver, Colorado |
| Authorized Official Name and Position | Julieann Bishop (CO-OWNER) |
| Authorized Official Contact | 3462211597 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 5280 Iom Pro, Llc Po Box 1651 Crosby TX 77532-1651 Ph: (281) 462-7684 | 5280 Iom Pro, Llc 1700 Bassett St Unit 1021 Denver CO 80202-1921 Ph: (346) 221-1597 |
| NPI Number | 1144779380 |
|---|---|
| Provider Enumeration Date | 09/29/2016 |
| Last Update Date | 09/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144779380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (Colorado) | Primary |
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