Colorado Provider Network Llc | |
1435 Garrison St Ste 110 Lakewood CO 80215-4748 | |
(720) 241-3765 | |
Not Available |
Full Name | Colorado Provider Network Llc |
---|---|
Speciality | Family Medicine - Adult Medicine |
Location | 1435 Garrison St Ste 110, Lakewood, Colorado |
Authorized Official Name and Position | John Edward Marquez (OWNER) |
Authorized Official Contact | 7202413765 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Colorado Provider Network Llc Po Box 12375 Denver CO 80212-0375 Ph: (970) 664-2497 | Colorado Provider Network Llc 1435 Garrison St Ste 110 Lakewood CO 80215-4748 Ph: (720) 241-3765 |
NPI Number | 1114602596 |
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Provider Enumeration Date | 06/21/2023 |
Last Update Date | 06/21/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114602596 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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