Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice | |
Chiropractor |
111N00000X | 35 | Chiropractic | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI Number | 1316406978 |
| LBN Legal business name | CHERRY CREEK MEDICAL GROUP |
| Authorized official | TARRYN FARRELL - (CFO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/13/2019 |
| Last updated | 05/06/2019 - About 7 years ago |
| Identifiers | n/a |
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CHERRY CREEK MEDICAL GROUP
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