| Grand Slam Supports | |
|
2313 Dunbar Ct Longmont CO 80501-1009 | |
| (316) 323-9734 | |
| Not Available |
| Full Name | Grand Slam Supports |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2313 Dunbar Ct, Longmont, Colorado |
| Authorized Official Name and Position | Tyler Patty (OWNER) |
| Authorized Official Contact | 3163239734 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Slam Supports 2313 Dunbar Ct Longmont CO 80501-1009 Ph: (316) 323-9734 | Grand Slam Supports 2313 Dunbar Ct Longmont CO 80501-1009 Ph: (316) 323-9734 |
| NPI Number | 1740751635 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740751635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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