Healthcare Provider Details

I. General information

NPI: 1427836683
Provider Name (Legal Business Name): ALL SEASONS AESTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 RIDGEMONT PL
HIGHLANDS RANCH CO
80126-5583
US

IV. Provider business mailing address

716 RIDGEMONT PL
HIGHLANDS RANCH CO
80126-5583
US

V. Phone/Fax

Practice location:
  • Phone: 720-808-7307
  • Fax:
Mailing address:
  • Phone: 720-808-7307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CASEY LENO
Title or Position: OWNER
Credential:
Phone: 720-808-7307