Organization
PEDIATRIC NEUROLOGY AND EPILEPSY SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA LICANO (LEAD CREDENTIALING)
(719) 638-1122
Entity
Organization
Contact information
Practice address
2055 N HIGH ST STE 300, DENVER, CO 80205-5568
(303) 226-7230
Mailing address
2055 N HIGH ST STE 300, DENVER, CO 80205-5568
(303) 226-7230
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
Other
Enumeration date
11/19/2024
Last updated
01/29/2025
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