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3 Superior Dr Ste 100b Superior CO 80027-8653 | |
| (303) 415-8940 | |
| (303) 425-9259 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3 Superior Dr Ste 100b, Superior, Colorado |
| Authorized Official Name and Position | William A Munson (VP, CFO) |
| Authorized Official Contact | 3034157433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 9049 Boulder CO 80301-9049 Ph: (303) 415-8940 | 3 Superior Dr Ste 100b Superior CO 80027-8653 Ph: (303) 415-8940 |
| NPI Number | 1053967869 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 06/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053967869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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