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General NPI Number Information
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NPI Number | 1154357788
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Entity Type | Organization
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Legal Business Name | CHERRY CREEK IMAGING, LLC
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 12687 W CEDAR DR SUITE 200
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City | LAKEWOOD
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State | CO
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Zip | 80228-2010
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Country | US
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Telephone | 303-355-4674
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Fax | 303-355-7865
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Provider Business Mailing Address
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Address Line | P.O. BOX 809
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City | DENVER
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State | CO
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Zip | 80206-0809
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Country | US
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Telephone | 303-468-1395
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Fax | 303-355-7865
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT P. ALLEN
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Credential | M.D.
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Telephone | 303-355-4674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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