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General NPI Number Information
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NPI Number | 1437321585
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Entity Type | Organization
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Legal Business Name | LORENA R. LETKOMILLER
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 300 EXEMPLA CIR STE 310
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City | LAFAYETTE
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State | CO
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Zip | 80026-3394
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Country | US
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Telephone | 303-664-1490
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Fax | 720-890-8869
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Provider Business Mailing Address
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Address Line | 300 EXEMPLA CIR STE 310
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City | LAFAYETTE
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State | CO
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Zip | 80026-3394
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Country | US
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Telephone | 303-664-1490
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Fax | 720-890-8869
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. LORENA REY LETKOMILLER
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Credential | M.D.
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Telephone | 303-664-1490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 39849
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License Number State | CO
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