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Organization
KETAMINE WEST LLC
Active
Organization
KETAMINE WEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STRYDER RIVER REILLY APRN (OWNER/OPERATOR)
(970) 644-1279
Entity
Organization
Contact information
Practice address
602 26 1/2 RD, GRAND JUNCTION, CO 81506-1905
(970) 427-4000
Mailing address
602 26 1/2 RD, GRAND JUNCTION, CO 81506-1905
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/16/2022
Last updated
12/20/2022
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