Organization
ELEVATION INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI LABRECQUE (ACCTS MGR)
(702) 453-3799
Entity
Organization
Contact information
Practice address
1501 E 3RD ST, DELTA, CO 81416-2815
(970) 874-7681
Mailing address
PO BOX 1112, DURANGO, CO 81302-1112
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
DR0044007
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR 0044007
CO LIC
CO
Enumeration date
08/29/2013
Last updated
08/29/2013
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