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General NPI Number Information
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NPI Number | 1235276494
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Entity Type | Organization
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Legal Business Name | MOUNTAIN MIDWIFERY CENTER, INC.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 3555 S CLARKSON ST SUITE 300
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3909
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Country | US
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Telephone | 303-788-0600
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Fax | 303-788-0602
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Provider Business Mailing Address
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Address Line | 3555 S CLARKSON ST SUITE 300
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3909
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Country | US
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Telephone | 303-788-0600
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Fax | 303-788-0602
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOEL L RYAN
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Credential | MS
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Telephone | 303-788-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number | 0159
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License Number State | CO
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