| NPI | 1174309231 |
|---|---|
| Doing Business As | IDENTITY HORMONES DENVER |
| Entity Type | Organization |
| Authorized Contact | TEAH PHILLIPS Credentialing Manager 901-205-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2023-11-13 |