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Organization
PEDIATRIC ASSOCIATES PROF LLC
Active
Organization
PEDIATRIC ASSOCIATES PROF LLC
Active
Parent organization
PEDIATRIC ASSOCIATES PROF LLC
Other names
Teen Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC ASSOCIATES PROF LLC
Authorized official
AMBER HICKERT (PRACTICE ADMINISTRATOR)
(970) 249-2421
Entity
Organization
Contact information
Practice address
910 S 4TH ST, MONTROSE, CO 81401-4226
(970) 249-2421
(970) 249-1203
Mailing address
947 S 5TH ST, MONTROSE, CO 81401-5716
(970) 249-2421
(970) 249-1203
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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