Healthcare Provider Details

I. General information

NPI: 1174026785
Provider Name (Legal Business Name): PROFESSIONAL SLEEP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2018
Last Update Date: 03/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S PARKER RD STE 100
DENVER CO
80231-2163
US

IV. Provider business mailing address

191 TELLURIDE ST UNIT 5
BRIGHTON CO
80601-4356
US

V. Phone/Fax

Practice location:
  • Phone: 303-396-5923
  • Fax: 303-957-5414
Mailing address:
  • Phone: 303-396-5923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JORDAN CAMDEN
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 303-396-5923