Organization
MILE HIGH DIABETES VEIN AND WOUND CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARNER HETTICK (MANAGING EMPLOYEE)
(303) 589-1589
Entity
Organization
Contact information
Practice address
12061 TEJON ST STE 600, WESTMINSTER, CO 80234-2325
(303) 457-0123
(303) 252-4065
Mailing address
12061 TEJON ST STE 600, WESTMINSTER, CO 80234-2325
(303) 457-0123
(303) 252-4065
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
01/28/2025
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