Organization
GLACIER ACUTE SURGERY PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISABELLE AUDET MD (OWNER)
(303) 452-0059
Entity
Organization
Contact information
Practice address
9351 GRANT ST, STE 400, THORNTON, CO 80229-4358
(303) 452-0059
Mailing address
PO BOX 11065, BOULDER, CO 80301-0001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
49355
CO
Other
Enumeration date
12/07/2011
Last updated
10/17/2016
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