Healthcare Provider Details

I. General information

NPI: 1811331788
Provider Name (Legal Business Name): ROCKY MOUNTAIN YOUTH MEDICAL & NURSING CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE SUITE 6600
DENVER CO
80218-1216
US

IV. Provider business mailing address

9197 GRANT ST SUITE 100
THORNTON CO
80229-4361
US

V. Phone/Fax

Practice location:
  • Phone: 303-869-2182
  • Fax: 303-869-1906
Mailing address:
  • Phone: 303-869-2179
  • Fax: 303-962-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE WOLK
Title or Position: OWNER
Credential: MD
Phone: 303-869-2182