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General NPI Number Information
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NPI Number | 1710966460
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN TOX, LLC
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 1701 CHAMBERS ROAD SUITE J
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City | AURORA
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State | CO
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Zip | 80011-4666
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Country | US
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Telephone | 303-749-0443
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Fax |
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Provider Business Mailing Address
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Address Line | 12015 E 46TH AVE SUITE 250
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City | DENVER
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State | CO
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Zip | 80239-3107
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Country | US
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Telephone | 855-895-8090
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Fax | 303-371-0345
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Authorized Official
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Title or Position | MGR OF CREDENTIALING/ENROLLMENT
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Name | SYLVIA LYNN FREEMAN
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Credential |
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Telephone | 508-304-7602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | CO
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