Organization
BOULDER PLASTIC SURGERY PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM GARCIA (OFFICE CONTACT)
(303) 443-2277
Entity
Organization
Contact information
Practice address
2525 4TH ST, BOULDER, CO 80304-3966
(303) 443-3672
Mailing address
PO BOX 7643, LOVELAND, CO 80537-0643
(970) 663-2742
(970) 342-2093
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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