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General NPI Number Information
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NPI Number | 1104657683
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Entity Type | Organization
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Legal Business Name | HYDRATION RESTORATION
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 2130 ARAPAHOE ST
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City | DENVER
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State | CO
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Zip | 80205-5416
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Country | US
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Telephone | 720-394-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 2992 S GRAPE WAY
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City | DENVER
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State | CO
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Zip | 80222-6857
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Country | US
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Telephone | 720-394-1366
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CHIEF MEDICAL OFFICER
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Name | DR. MARY GOMEZ CHAMBERS
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Credential | DNP, CNM, RN
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Telephone | 720-394-1366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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