Organization
COLORADO ATHLETIC CONDITIONING CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE STAACK (PRACTICE ADMINISTRATOR)
(303) 680-6121
Entity
Organization
Contact information
Practice address
3451 S CHAMBERS RD, AURORA, CO 80014-5073
(303) 680-6121
(303) 680-8627
Mailing address
PO BOX 173796, DEPT COL, DENVER, CO 80217-3796
(303) 680-6121
(303) 680-8627
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/05/2006
Last updated
06/17/2010
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