Organization
WESTLAKE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY GHISELLI M.D. (OWNER)
(303) 888-7742
Entity
Organization
Contact information
Practice address
7800 E ORCHARD RD, SUITE 100, GREENWOOD VILLAGE, CO 80111-2583
(303) 783-1300
(303) 783-1200
Mailing address
140 IVANHOE ST, DENVER, CO 80220-5840
(303) 888-7742
(303) 783-1200
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2415
CO
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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