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Organization

SUMMIT KETAMINE, PC

Active
Other names
Summit Ketamine Innovations
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SARAH LYNN COAKLEY DO (PRESIDENT)
(719) 641-7614
Entity
Organization

Contact information

Practice address
19284 COTTONWOOD DR STE 200, PARKER, CO 80138-3881
(719) 641-7614
Mailing address
2077 S CLARKSON ST, DENVER, CO 80210-4105
(719) 641-7614

Taxonomy

Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1578616413
PERSONAL NPI
Enumeration date
03/18/2019
Last updated
03/18/2019
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