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General NPI Number Information
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NPI Number | 1275786154
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Entity Type | Organization
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Legal Business Name | METRO SURGICAL SERVICES LLC
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 23061 E ALAMO PL
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City | AURORA
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State | CO
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Zip | 80015-6673
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Country | US
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Telephone | 303-484-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 23061 E ALAMO PL
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City | AURORA
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State | CO
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Zip | 80015-6673
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Country | US
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Telephone | 303-484-1580
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Fax |
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Authorized Official
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Title or Position | CFA/OWNER
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Name | AMY E FANNING
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Credential | CFA
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Telephone | 303-484-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 108079
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License Number State | CO
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