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General NPI Number Information
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NPI Number | 1215385455
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Entity Type | Organization
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Legal Business Name | TRUTH SOLDIER LLC
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Dates
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Enumeration Date | 05/27/2016
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 1200 W SOUTH BOULDER RD STE 103
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City | LAFAYETTE
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State | CO
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Zip | 80026-2833
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Country | US
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Telephone | 303-954-9864
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Fax | 303-963-5782
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Provider Business Mailing Address
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Address Line | 1200 W SOUTH BOULDER RD STE 103
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City | LAFAYETTE
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State | CO
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Zip | 80026-2833
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Country | US
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Telephone | 303-954-9864
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Fax | 303-963-5782
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID DOUGLAS ROBINSON
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Credential |
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Telephone | 303-954-9864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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