Organization
SOUTH LOGAN FAMILY PRACTICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI LAWS (OFFICE MANAGER)
(303) 733-3764
Entity
Organization
Contact information
Practice address
895 S LOGAN ST, DENVER, CO 80209-4197
(303) 733-3764
(303) 733-0868
Mailing address
895 S LOGAN ST, DENVER, CO 80209-4197
(303) 733-3764
(303) 733-0868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26202
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01262021
—
CO
Enumeration date
07/03/2007
Last updated
05/06/2009
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