Organization
MTA MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AINUR SADYGULOVA (CO-OWNER)
(720) 269-4539
Entity
Organization
Contact information
Practice address
2620 S PARKER RD STE 273, AURORA, CO 80014-1627
(720) 269-4539
(720) 269-4539
Mailing address
2620 S PARKER RD STE 273, AURORA, CO 80014-1627
(720) 269-4539
(720) 269-4539
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36157938
STATE TAX LICENCE
CO
Enumeration date
06/26/2019
Last updated
06/26/2019
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