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Individual

LARISA Y RAVDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1421 S POTOMAC ST STE 320, AURORA, CO 80012-4512
(303) 750-1920
(303) 750-0483
Mailing address
1421 S POTOMAC ST STE 320, AURORA, CO 80012-4512
(303) 750-1920
(303) 750-0483

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
40458
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1407007461
IA
Enumeration date
10/08/2008
Last updated
06/13/2013
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