Colorado Provider Network LLC

NPI #1114602596 in Lakewood, Colorado

Provider Information

NPI Number
1114602596
Entity Type
Organization
Organization Name
Colorado Provider Network LLC
Primary Specialty
Family Medicine - Adult Medicine
Enumeration Date
Jun 21, 2023
Last Updated
Jun 21, 2023

Practice Location

Address
1435 GARRISON ST STE 110
ZIP Code
80215-4748
Phone
(720) 241-3765

Authorized Official

Name
JOHN EDWARD MARQUEZ
Title
OWNER
Phone
(720) 241-3765

Specialties & Taxonomy Codes

Specialty
Family Medicine - Adult MedicineAdult Medicine

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