Provider Demographics
NPI:1194246058
Name:ASCENT MEDICAL LLC
Entity type:Organization
Organization Name:ASCENT MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:JULIANO
Authorized Official - Last Name:CONDER
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:615-438-0065
Mailing Address - Street 1:757 E 20TH AVE
Mailing Address - Street 2:SUITE 370 #831
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205
Mailing Address - Country:US
Mailing Address - Phone:303-362-6615
Mailing Address - Fax:720-372-6751
Practice Address - Street 1:5375 W 73RD PLACE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80003
Practice Address - Country:US
Practice Address - Phone:720-372-6751
Practice Address - Fax:303-362-6615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-30
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty