Organization
IANNOTTI LIFESTYLE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ROBERT IANNOTTI MD (PHYSICIAN/ OWNER)
(720) 773-1352
Entity
Organization
Contact information
Practice address
150 OLD LARAMIE TRL E, SUITE 210, LAFAYETTE, CO 80026-7018
(720) 773-1352
(303) 604-6958
Mailing address
150 OLD LARAMIE TRL E, SUITE 210, LAFAYETTE, CO 80026-7018
(720) 773-1352
(303) 604-6958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0039567
CO
Other
Enumeration date
05/03/2016
Last updated
07/26/2016
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