Organization Name: | ASPEN INTEGRATED MEDICINE INC |
NPI Number: | 1215167861 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN CLEVELAND HUGHES (PHYSICIAN) |
Mailing Address: | 227 Midland Ave 18b Basalt |
State: | CO US |
Postal Code: | 816218364 |
Phone Number: | 9709270308 |
Fax Number: | 9709270394 |
NPI Enumeration Date: | 07/16/2009 |
NPI Last Update Date: | 11/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 47944 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |