Organization
SOUTH POINTE OCCUPATIONAL MEDICINE AND FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA CAMPBELL (MANAGER)
(970) 351-2412
Entity
Organization
Contact information
Practice address
150 OLD LARAMIE TRAIL, SUITE 210, LAFAYETTE, CO 80026-7085
(970) 351-3030
Mailing address
150 OLD LARAMIE TRAIL, SUITE 210, LAFAYETTE, CO 80026-7085
(970) 351-3030
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
32068
CO
261QX0100X
Occupational Medicine Clinic/Center
32068
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01320688
—
CO
Enumeration date
09/09/2010
Last updated
04/08/2021
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