Organization
COLORADO LASER CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT T MOTAZEDI M.D. (PRESIDENT)
(719) 596-4000
Entity
Organization
Contact information
Practice address
1985 DOMINION WAY, COLORADO SPRINGS, CO 80918-1476
(719) 596-4000
Mailing address
1985 DOMINION WAY, COLORADO SPRINGS, CO 80918-1476
(719) 596-4000
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
27602
CO
Other
Enumeration date
04/16/2013
Last updated
04/16/2013
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