Healthcare Provider Details

I. General information

NPI: 1972773232
Provider Name (Legal Business Name): FAMILY CENTERED MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S ONEIDA ST STE 248
DENVER CO
80224-2551
US

IV. Provider business mailing address

2121 S ONEIDA ST STE 248
DENVER CO
80224-2551
US

V. Phone/Fax

Practice location:
  • Phone: 303-504-0600
  • Fax:
Mailing address:
  • Phone: 303-504-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER THOMAS PRUTCH
Title or Position: OWNER
Credential: NP
Phone: 303-504-0600