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General NPI Number Information
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NPI Number | 1306221924
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSISTANCE
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 6121 WINDEMERE RD
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City | LOVELAND
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State | CO
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Zip | 80537-7012
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Country | US
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Telephone | 720-626-3692
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Fax |
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Provider Business Mailing Address
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Address Line | 6121 WINDEMERE RD
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City | LOVELAND
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State | CO
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Zip | 80537-7012
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Country | US
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Telephone | 720-626-3692
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA LINBOE
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Credential |
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Telephone | 720-626-3692
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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 | 1171
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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