Provider First Line Business Practice Location Address:
2100 BROADWAY
Provider Second Line Business Practice Location Address:
STOUT STREET CLINIC INTEGRATED BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80205-2526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-312-9577
Provider Business Practice Location Address Fax Number:
303-293-6511
Provider Enumeration Date:
07/20/2011