Organization
PORTERCARE ADVENTIST HEALTH SYSTEM
Active
Organization
PORTERCARE ADVENTIST HEALTH SYSTEM
Active
Other names
Neurosurgery One Lakewood
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON TACHA (COO)
(303) 304-7752
Entity
Organization
Contact information
Practice address
12596 W BAYAUD AVE STE 100, LAKEWOOD, CO 80228-2035
(720) 638-7500
(720) 583-6770
Mailing address
PO BOX 713425, CHICAGO, IL 60677-4325
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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