Organization
ENDOSCOPY CENTER AT PORTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE GOUDZWAARD CEO (CEO)
(303) 205-1090
Entity
Organization
Contact information
Practice address
2535 S DOWING ST, SUITE 320, DENVER, CO 80210
(303) 722-8987
(303) 722-2935
Mailing address
1001 SOUTHPARK DR, LITTLETON, CO 80120-5641
(303) 722-8987
(303) 722-2935
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40050351
—
CO
Enumeration date
05/15/2007
Last updated
08/20/2014
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