Organization
BOULDER MEDICAL CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASANDRA RICHARDS (CREDENTIALING COORDINATOR)
(303) 440-3076
Entity
Organization
Contact information
Practice address
1551 PROFESSIONAL LN UNIT 240, LONGMONT, CO 80501-6967
(303) 938-4710
Mailing address
2750 BROADWAY ST, BOULDER, CO 80304-3573
(303) 440-3000
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/08/2024
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