Organization
POTOMAC SQUARE FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRESA SWITZER (CORPORATE CONTROLLER)
(303) 341-4730
Entity
Organization
Contact information
Practice address
2595 S LEWIS WAY STE A, LAKEWOOD, CO 80227-6555
(303) 986-9583
Mailing address
PO BOX 173848, DENVER, CO 80217-3848
(303) 945-3299
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72602554
—
CO
Enumeration date
07/28/2020
Last updated
09/15/2020
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