Organization
MOUNTAIN PEACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN C RISTOW M.D. (PRESIDENT)
(970) 385-7295
Entity
Organization
Contact information
Practice address
1 MERCADO ST, SUITE 205, DURANGO, CO 81301-7300
(970) 385-7295
(970) 385-7299
Mailing address
1 MERCADO ST, SUITE 205, DURANGO, CO 81301-7300
(970) 385-7295
(970) 385-7299
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
46157
CO
Other
Enumeration date
06/14/2008
Last updated
06/14/2008
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