Healthcare Provider Details

I. General information

NPI: 1467845586
Provider Name (Legal Business Name): ROCKY MOUNTAIN VETERINARY CARDIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 03/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 WALNUT ST
BOULDER CO
80301-2526
US

IV. Provider business mailing address

3640 WALNUT ST
BOULDER CO
80301-2526
US

V. Phone/Fax

Practice location:
  • Phone: 303-443-4569
  • Fax: 303-443-4568
Mailing address:
  • Phone: 303-443-4569
  • Fax: 303-443-4568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberVET.0009890
License Number StateCO

VIII. Authorized Official

Name: DR. KAREN SANDERSON
Title or Position: VETERINARY CARDIOLOGIST/OWNER
Credential: DVM
Phone: 303-443-4569