# IDENTITY HORMONES CO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Identity Hormones Denver
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174309231
- **Authorized official:** TEAH PHILLIPS (CREDENTIALING MANAGER)
- **Authorized official phone:** (901) 205-3999

## Contact information

- **Practice address:** 7305 E 29TH AVE STE 220, DENVER, CO 80238-2701
- **Practice address phone:** (602) 354-3925
- **Mailing address:** 7305 E 29TH AVE STE 220, DENVER, CO 80238-2701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/05/2023
- **Last updated:** 11/13/2023