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1154658664
AMELIA SITA RAVISHANKARA
BOULDER, CO
NPI
1154658664
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
Enumeration Date
2009-11-05
Last Update Date
2009-11-05
Business Address
-- AMELIA SITA RAVISHANKARA
580 MOHAWK DRIVE BASELINE MEDICAL OFFICE
BOULDER, CO 80302
Phone number: 303-614-1400
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Mailing Address
-- AMELIA SITA RAVISHANKARA
7931 W 55TH AVE APT 202
ARVADA, CO 80002-3704
Phone number: 720-352-0892
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