NPI 1114513009

Boulder Plastic Surgery Prof LLC

Organisation Specialist Longmont, CO

Practice location

Address: 1750 E Ken Pratt Blvd, Longmont, CO 80504-5311
Phone: (720) 718-7000
Mailing address: PO Box 7643, Loveland, CO 80537-0643

Authorised official

Name: Pam Garcia
Title: Office Contact
Phone: (303) 443-2277

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1114513009
Entity type: Organization
NPI issued: 15 Dec 2020
Record last updated: 15 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.