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General NPI Number Information
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NPI Number | 1922738228
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC PROFESSIONAL ASSOCIATION P.C.
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 1032 S 88TH ST
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City | LOUISVILLE
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State | CO
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Zip | 80027-9452
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Country | US
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Telephone | 303-665-0286
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Fax |
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Provider Business Mailing Address
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Address Line | 4820 RIVERBEND RD STE 200
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City | BOULDER
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State | CO
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Zip | 80301-2618
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Country | US
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Telephone | 303-665-0286
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY R GAGLIANO
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Credential |
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Telephone | 303-665-0286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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