Provider Demographics
NPI:1083248603
Name:ANNEST SYNN NOWAK & MUBARAK PROFESSIONAL LLC
Entity Type:Organization
Organization Name:ANNEST SYNN NOWAK & MUBARAK PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTOLLER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFRIE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DRURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-539-0736
Mailing Address - Street 1:1601 E 19TH AVE STE 3950
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1256
Mailing Address - Country:US
Mailing Address - Phone:303-539-0736
Mailing Address - Fax:303-539-0737
Practice Address - Street 1:310 COUNTY ROAD 14
Practice Address - Street 2:
Practice Address - City:DEL NORTE
Practice Address - State:CO
Practice Address - Zip Code:81132-8758
Practice Address - Country:US
Practice Address - Phone:719-657-2510
Practice Address - Fax:713-657-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty