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NPI Code Detail

MEDICARE: ROCKY MOUNTAIN ANAPLASTOLOGY INC

MEDICARE: ROCKY MOUNTAIN ANAPLASTOLOGY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1700XOcularist
2156FX1800XOptician
3224900000XMastectomy Fitter
4332BC3200XCustomized Equipment (DME)
5335E00000XProsthetic/Orthotic Supplier
6229N00000XAnaplastologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679002356
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKY MOUNTAIN ANAPLASTOLOGY INC
Provider Business Mailing Address
First Line : 255 UNION BLVD STE 230
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-1861
Country : US
Telephone Number : 303-973-8482
Fax Number : 303-973-8468
Provider Business Practice Location Address
First Line : 3405 S YARROW ST UNIT C
Second Line :
City : LAKEWOOD
State : CO
Zip : 80227-4901
Country : US
Telephone Number : 303-973-8482
Fax Number : 303-973-8468
Authorized Official
Title or Position : PRESIDENT
Name : BARBARA Y LILLO
Credential :
Telephone Number : 303-973-8482
Provider Enumeration Date : 06/07/2017
Last Update Date : 02/06/2024

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Directions to “ROCKY MOUNTAIN ANAPLASTOLOGY INC ” Practice Location

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