Organization
PATHOLOGY ASSOC OF THE ROARING FORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY S STEINBRECHER MD (PRESIDENT PATHOLOGIST)
(970) 945-6535
Entity
Organization
Contact information
Practice address
1906 BLAKE AVE, GLENWOOD SPGS, CO 81601-4227
(970) 945-6535
Mailing address
PO BOX 2725, GLENWOOD SPGS, CO 81602-2725
(970) 945-1443
(970) 947-9410
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04020681
—
CO
01
—
PA636752
BLUE CROSS
—
Enumeration date
01/18/2006
Last updated
10/12/2007
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