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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