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General NPI Number Information
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NPI Number | 1336594381
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Entity Type | Organization
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Legal Business Name | PEEP CLINIC
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Dates
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Enumeration Date | 04/27/2016
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | 6179 S BALSAM WAY #205
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City | LITTLETON
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State | CO
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Zip | 80123-3091
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Country | US
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Telephone | 720-771-1135
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Fax |
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Provider Business Mailing Address
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Address Line | 9249 S BROADWAY #200-268
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-5690
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Country | US
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Telephone | 720-771-1135
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MICHELLE MCGARRY
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Credential | CPNP
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Telephone | 720-771-1135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | APN.0992162-NP
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License Number State | CO
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