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General NPI Number Information
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NPI Number | 1891186987
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTER,LLC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 11 W DRY CREEK CIR SUITE 120
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City | LITTLETON
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State | CO
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Zip | 80120-8077
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Country | US
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Telephone | 303-955-5555
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Fax | 720-463-1090
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Provider Business Mailing Address
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Address Line | 11 W DRY CREEK CIR SUITE 120
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City | LITTLETON
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State | CO
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Zip | 80120-8077
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Country | US
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Telephone | 303-955-5555
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Fax | 720-463-1090
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID VANSICKLE
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Credential | MD
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Telephone | 720-339-3283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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