Organization
K2 DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVY BRADSHAW KOGER (PRACTICE MANAGER)
(303) 579-5929
Entity
Organization
Contact information
Practice address
3434 47TH ST STE 200, BOULDER, CO 80301-1817
(303) 444-8100
Mailing address
1165 LINDEN CIR, BOULDER, CO 80304-0743
(303) 579-5929
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
07/01/2022
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