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General NPI Number Information
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NPI Number | 1194246058
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Entity Type | Organization
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Legal Business Name | ASCENT MEDICAL LLC
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 5375 W 73RD PLACE
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City | WESTMINSTER
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State | CO
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Zip | 80003
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Country | US
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Telephone | 720-372-6751
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Fax | 303-362-6615
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Provider Business Mailing Address
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Address Line | 757 E 20TH AVE SUITE 370 #831
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City | DENVER
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State | CO
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Zip | 80205
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Country | US
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Telephone | 303-362-6615
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Fax | 720-372-6751
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Authorized Official
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Title or Position | CO-OWNER
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Name | JILLIAN JULIANO CONDER
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Credential | CNIM
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Telephone | 615-438-0065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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