Organization
TJDMEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY GARDNER DO (OWNER)
(720) 898-8900
Entity
Organization
Contact information
Practice address
4251 KIPLING ST, SUITE 560, WHEAT RIDGE, CO 80033-2896
(720) 898-8900
(720) 898-8901
Mailing address
4251 KIPLING ST, SUITE 560, WHEAT RIDGE, CO 80033-2896
(720) 898-8900
(720) 898-8901
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
39589
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83685731
—
CO
Enumeration date
01/03/2008
Last updated
01/03/2008
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