Organization
PORTERCARE ADVENTIST HEALTH SYSTEM
Active
Other names
AdventHealth Medical Group Breast Surgery at Lone Tree
Organization subpart
No
Provider details
NPI number
Authorized official
JASON TACHA (COO)
(303) 304-7752
Entity
Organization
Contact information
Practice address
9695 S YOSEMITE ST STE 385, LONE TREE, CO 80124-2890
(303) 715-7119
(303) 879-6180
Mailing address
PO BOX 713425, CHICAGO, IL 60677-4325
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/30/2024
Last updated
12/30/2024
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