Organization
ADVANCED DERMATOLOGY OF COLORADO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DECLUE (DIRECTOR-PROVIDER SERVICES)
(407) 875-2080
Entity
Organization
Contact information
Practice address
1100 POUDRE RIVER DR UNIT A, FORT COLLINS, CO 80524-3557
(970) 484-6303
(970) 484-3036
Mailing address
151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 32751-7176
(407) 875-2080
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/17/2015
Last updated
11/06/2018
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