Organization
ROARING FORK DERMATOLOGY INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIAN RAMSEY MELLETTE JR. MD (OWNER)
(970) 927-4731
Entity
Organization
Contact information
Practice address
23262 TWO RIVERS RD, BASALT, CO 81621-9227
(970) 927-4731
(970) 927-4420
Mailing address
PO BOX 1489, BASALT, CO 81621-1489
(970) 927-4731
(970) 927-4420
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
CO
Other
Enumeration date
12/10/2007
Last updated
06/19/2008
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