Stacy Green Enterprises, LLC

NPI #1871262253 in Boulder, Colorado

Provider Information

NPI Number
1871262253
Entity Type
Organization
Organization Name
Stacy Green Enterprises, LLC
Primary Specialty
Clinic/Center - Health Service
Enumeration Date
Sep 9, 2021
Last Updated
Oct 22, 2025

Practice Location

Address
825 S BROADWAY ST STE 100
ZIP Code
80305-5932
Phone
(303) 717-2521

Authorized Official

Name
STACY ROBIN GREEN, MD
Title
OWNER
Phone
(303) 717-2521

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Health ServiceHealth Service

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