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Organization

BOULDER VALLEY IOM, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEXANDRA LEWIS (ONWER)
(202) 316-9902
Entity
Organization

Contact information

Practice address
3492 W 155TH AVE, BROOMFIELD, CO 80023-4100
(202) 316-9902
(303) 302-1591
Mailing address
5023 W 120TH AVE, PO BOX 236, BROOMFIELD, CO 80020-5606
(303) 803-4004
(303) 302-1591

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Enumeration date
08/24/2017
Last updated
03/07/2024
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