Organization
IDENTITY HORMONES CO LLC
Active
Other names
Identity Hormones Denver
Organization subpart
No
Provider details
NPI number
Authorized official
TEAH PHILLIPS (CREDENTIALING MANAGER)
(901) 205-3999
Entity
Organization
Contact information
Practice address
7305 E 29TH AVE STE 220, DENVER, CO 80238-2701
(602) 354-3925
Mailing address
7305 E 29TH AVE STE 220, DENVER, CO 80238-2701
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
09/05/2023
Last updated
11/13/2023
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