Organization
JLA MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAINE GERRITSEN (BILLING AGENT)
(303) 499-2217
Entity
Organization
Contact information
Practice address
255 CANYON BLVD, SUITE 300, BOULDER, CO 80302-4979
(303) 449-7541
Mailing address
1062 LOVE CT, BOULDER, CO 80303-2975
(303) 499-2217
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18076
CO
Other
Enumeration date
05/03/2007
Last updated
01/09/2008
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