Healthcare Provider Details

I. General information

NPI: 1831686682
Provider Name (Legal Business Name): VSI PROVIDERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 RIDGELINE BLVD STE 100
HIGHLANDS RANCH CO
80129-2392
US

IV. Provider business mailing address

9135 RIDGELINE BLVD STE 100
HIGHLANDS RANCH CO
80129-2392
US

V. Phone/Fax

Practice location:
  • Phone: 440-714-7149
  • Fax: 303-845-9573
Mailing address:
  • Phone: 440-714-7149
  • Fax: 303-845-9573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MISS ANGEL K WALKER
Title or Position: MEDICAL BILLING SPECIALIST
Credential:
Phone: 561-932-6943