Organization
PROFESSIONAL ALLIANCE SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL BEALE (PRESIDENT)
(303) 716-5738
Entity
Organization
Contact information
Practice address
2251 S ZANG CT, LAKEWOOD, CO 80228-4365
(303) 716-5738
Mailing address
2251 S ZANG CT, LAKEWOOD, CO 80228-4365
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA0001073
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417919770
—
CO
Enumeration date
11/25/2014
Last updated
11/25/2014
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