MARILLAC CLINIC, INC

GRAND JUNCTION, CO
NPI1104275882
Entity TypeOrganization
Authorized ContactLATA RAMACHANDRAN
Executive Director
970-298-2235
Organization Subpart ?No
Primary Taxonomy261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)
(Licence: CO  18U295)
Additional Taxonomies261QD0000X Clinic/Center, Dental
Enumeration Date2016-06-03
Last Update Date2020-09-21
Business Address
MARILLAC CLINIC, INC
510 29 1/2 RD
GRAND JUNCTION, CO 81504
Phone number: 970-298-1782
Mailing Address
MARILLAC CLINIC, INC
2333 N 6TH ST
GRAND JUNCTION, CO 81501-2001
Phone number: 970-298-1782