Provider First Line Business Practice Location Address:
605 BANNOCK ST
Provider Second Line Business Practice Location Address:
UNIT 3 DENVER METRO HEALTH CLINIC
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-4505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-602-3542
Provider Business Practice Location Address Fax Number:
303-602-3551
Provider Enumeration Date:
11/09/2008