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Organization

ST. VRAIN SURGICAL ASSISTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BILL J PARKER PA/C (OWNER/MGR)
(303) 819-2025
Entity
Organization

Contact information

Practice address
77 BAYLOR DR, LONGMONT, CO 80503-2148
(303) 819-2025
(720) 494-0995
Mailing address
77 BAYLOR DR, LONGMONT, CO 80503-2148
(303) 819-2025
(720) 494-0995

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
519
CO

Other

Enumeration date
08/30/2006
Last updated
11/06/2007
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