Healthcare Provider Details

I. General information

NPI: 1689001695
Provider Name (Legal Business Name): PRECISION SURGICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19696 E PINEWOOD DR
AURORA CO
80016-3880
US

IV. Provider business mailing address

PO BOX 461206
AURORA CO
80046-1206
US

V. Phone/Fax

Practice location:
  • Phone: 303-525-1698
  • Fax: 303-827-3402
Mailing address:
  • Phone: 303-525-1698
  • Fax: 303-827-3402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH L GALLEGOS
Title or Position: PRESIDENT
Credential: CSFA
Phone: 303-525-1698