Provider First Line Business Practice Location Address:
12600 W COLFAX AVENUE
Provider Second Line Business Practice Location Address:
SUITE B 420 ASPEN GROVE COUNSELING CENTER
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-922-0077
Provider Business Practice Location Address Fax Number:
303-674-6957
Provider Enumeration Date:
01/05/2007