Organization
CRESTED BUTTE PEDIATRICS PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M SANDERFORD MD (SOLE MEMBER)
(954) 294-1963
Entity
Organization
Contact information
Practice address
419 6TH STREET, SUITE 202, CRESTED BUTTE, CO 81224
(970) 349-6606
(866) 682-6309
Mailing address
PO BOX 167, CRESTED BUTTE, CO 81224-0167
(970) 349-6606
(866) 682-6309
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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