|
| |
|
755 Highway 105 Ste D Palmer Lake CO 80133-8902 | |
| (719) 229-2046 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Preventive Medicine - Addiction Medicine |
| Location | 755 Highway 105 Ste D, Palmer Lake, Colorado |
| Authorized Official Name and Position | Ken A Jenson (MANAGER) |
| Authorized Official Contact | 7192292046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9350 S 150 E Ste 320 Sandy UT 84070-2707 Ph: (385) 352-9696 | 755 Highway 105 Ste D Palmer Lake CO 80133-8902 Ph: (719) 229-2046 |
| NPI Number | 1730719394 |
|---|---|
| Provider Enumeration Date | 01/23/2020 |
| Last Update Date | 10/14/2024 |
| Certification Date | 10/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730719394 | NPI | - | NPPES |
Monumental Therapy Group Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 755 Highway 105 Unit 2c, Palmer Lake, CO 80133 Phone: 719-357-6175 |