Organization
DENVER NEUROLOGICAL CLINIC PROFESSIONAL LLC
Active
Organization
DENVER NEUROLOGICAL CLINIC PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MOON (OWNING PHYSICIAN)
(303) 715-9024
Entity
Organization
Contact information
Practice address
9980 PARK MEADOWS DR STE 100, LONE TREE, CO 80124-8404
(303) 715-9024
(303) 715-5020
Mailing address
9980 PARK MEADOWS DR STE 100, LONE TREE, CO 80124-8404
(303) 715-9024
(303) 715-5020
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000166943
—
CO
Enumeration date
10/14/2020
Last updated
08/31/2023
Update your record
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