Epiphany Dermatology Of Colorado, LLC
Dermatology in Grand Junction, CO. Organization (NPI-2).
NPI number1194340802
StatusActive
Last updated in NPPESDec 7, 2023
Details
- NPI
- 1194340802
- Entity type
- Organization (NPI-2)
- Legal business name
- Epiphany Dermatology Of Colorado, LLC
- Organization subpart
- No
- Enumeration date
- Jun 9, 2020
- Certification date
- Dec 7, 2023
- Last updated
- Dec 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Practice location
2530 N 8th St Ste 205Grand Junction, CO 81501-8858
Phone 970-245-1500
Mailing address
7300 Ranch Rd. 2222, Bldg 1, Ste 200Austin, TX 78730
Phone 512-628-0465
Authorized official
Gheorghe Pusta
Ceo
5129605760
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