Organization
BRIAR ROSE MEDICAL GROUP,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW CARSON PONDER MD (CO-OWNER)
(844) 355-7673
Entity
Organization
Contact information
Practice address
3350 PEORIA ST, STE 120, AURORA, CO 80010-1483
(844) 355-7673
(720) 729-8100
Mailing address
3350 PEORIA ST, STE 120, AURORA, CO 80010-1483
(844) 355-7673
(720) 729-8100
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0054605
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24523348
—
CO
05
—
33439257
—
CO
Enumeration date
03/14/2017
Last updated
11/08/2017
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