Organization
CASTLE VALLEY CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO ELLYN BRADLEY (PRACTICE MANAGER)
(970) 984-3333
Entity
Organization
Contact information
Practice address
2615 DOLORES WAY UNIT 103, CARBONDALE, CO 81623-2238
(970) 984-3333
(970) 984-0293
Mailing address
820 CASTLE VALLEY BLVD STE 204, NEW CASTLE, CO 81647-9453
(970) 984-3333
(970) 984-0293
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08189731
—
CO
Enumeration date
09/03/2019
Last updated
01/07/2020
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