Organization
WHEAT RIDGE GENERAL AND VASCULAR SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A DEFEYTER (SECRETARY)
(303) 431-2900
Entity
Organization
Contact information
Practice address
7805 W 38TH AVE, WHEAT RIDGE, CO 80033-6109
(303) 431-2900
(303) 431-2999
Mailing address
7805 W 38TH AVE, WHEAT RIDGE, CO 80033-6109
(303) 431-2900
(303) 431-2999
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
29993
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04020210
—
CO
Enumeration date
11/17/2006
Last updated
02/17/2010
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