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General NPI Number Information
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NPI Number | 1174010011
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Entity Type | Organization
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Legal Business Name | DTC SURGERY CENTER, LLC
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 135 INVERNESS DR E
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5115
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Country | US
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Telephone | 303-220-0810
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Fax |
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Provider Business Mailing Address
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Address Line | 4380 S SYRACUSE ST STE 120
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City | DENVER
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State | CO
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Zip | 80237-3094
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MS. LISA MALINAK
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Credential |
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Telephone | 32-200-8193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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