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General NPI Number Information
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NPI Number | 1861961021
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Entity Type | Organization
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Legal Business Name | CASTLE ROCK MEDICAL WEIGHT LOSS CENTER LLC
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Dates
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Enumeration Date | 11/17/2018
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Last Update Date | 11/17/2018
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Provider Practice Location Address
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Address Line | 1 OAKWOOD PARK PLZ STE 206
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City | CASTLE ROCK
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State | CO
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Zip | 80104-1849
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Country | US
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Telephone | 720-924-2548
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Fax | 303-814-1390
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Provider Business Mailing Address
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Address Line | 1 OAKWOOD PARK PLZ STE 206
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City | CASTLE ROCK
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State | CO
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Zip | 80104-1849
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Country | US
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Telephone | 720-924-2548
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Fax | 303-814-1390
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Authorized Official
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Title or Position | NURSE PRACTITIONER/CO-OWNER
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Name | MRS. CLARISSA ALUMBAUGH
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Credential | NP
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Telephone | 720-924-2548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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