Organization
GRAPEVINE MEDICAL LLC
Active
Organization
GRAPEVINE MEDICAL LLC
Active
Other names
MindGenesis
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET PARRA (MANAGER/MEMBER)
(303) 577-5800
Entity
Organization
Contact information
Practice address
991 SOUTHPARK DR, SUITE 200, LITTLETON, CO 80120-5688
(303) 577-5800
Mailing address
991 SOUTHPARK DR, SUITE 200, LITTLETON, CO 80120-5688
(303) 577-5800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1171-01
CO
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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