Organization
PETER GROTUSS MD PC
Active
Other names
ROARING FORK DERMATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIAN RAMSEY MELLETTE MD (DIRECTOR)
(970) 927-4731
Entity
Organization
Contact information
Practice address
23262 TWO RIVERS RD, BASALT, CO 81621-9227
(970) 927-4731
(970) 927-4420
Mailing address
PO BOX 1489, BASALT, CO 81621-1489
(970) 927-4731
(970) 927-4420
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20541
CO
Other
Enumeration date
02/16/2007
Last updated
08/22/2020
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