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Organization

DIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER DIVINE M.D. (OWNER)
(970) 388-2850
Entity
Organization

Contact information

Practice address
1260 DOCTORS LN, FORT COLLINS, CO 80524-4038
(813) 765-8453
Mailing address
1260 DOCTORS LN STE A, FORT COLLINS, CO 80524-4072
(970) 286-2668

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
DR.0058205
CO

Other

Enumeration date
04/06/2017
Last updated
09/10/2024
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