Organization
LEADVILLE MEDICAL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL BRIDGE (BUSINESS ADMINISTRATOR)
(719) 486-1264
Entity
Organization
Contact information
Practice address
825 W 6TH ST, LEADVILLE, CO 80461-2205
(719) 486-1264
(719) 486-1286
Mailing address
825 W 6TH ST, LEADVILLE, CO 80461-2205
(719) 486-1264
(719) 486-1286
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/15/2006
Last updated
06/01/2011
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