Organization
MOUNTAIN MIDWIFERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL L RYAN MS (OWNER)
(303) 788-0600
Entity
Organization
Contact information
Practice address
3555 S CLARKSON ST, SUITE 300, ENGLEWOOD, CO 80113-3909
(303) 788-0600
(303) 788-0602
Mailing address
3555 S CLARKSON ST, SUITE 300, ENGLEWOOD, CO 80113-3909
(303) 788-0600
(303) 788-0602
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
0159
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40G369
STATE LICENSE NUMBER
CO
05
—
63674351
—
CO
Enumeration date
01/30/2007
Last updated
01/31/2014
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