Organization
EXOTIC LOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTA BACHAYEVA (OWNER /EMPLOYEE)
(720) 290-8608
Entity
Organization
Contact information
Practice address
2150 S BELLAIRE ST STE 106, DENVER, CO 80222-4931
(720) 290-8608
Mailing address
PO BOX 221575, DENVER, CO 80222-1015
(720) 290-8608
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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