is a Diagnostic Radiology in Glenwood Springs, Colorado. practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for is 1376594978. The last update date is .
's current location address is 1906 Blake Ave, Glenwood Springs, Colorado. You can contact this provider via phone number 9704474065. The mailing address for is 1906 Blake Ave, Glenwood Springs, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1906 Blake Ave, Glenwood Springs, Colorado |
| Phone Number | 9704474065 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1376594978 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1906 Blake Ave |
|---|---|
| City | Glenwood Springs |
| State | Colorado (CO) |
| Post Code | 8160142270 |
| Phone Number | 9704474065 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
| Licence No | 6719 |
|
Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| NV3798 | NV | BCBS | |
| NV4882 | NV | BCBS | |
| 200290012 | NV | -- | |
| 153101 | NV | WC | |
| 152973 | NV | WC |
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