Provider Demographics
NPI:1083919310
Name:ROCKY MOUNTAIN HEALTH DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HEALTH DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADEN
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPSGT, EMT-B
Authorized Official - Phone:720-427-7807
Mailing Address - Street 1:9527 PEARL CIR. #202
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7697
Mailing Address - Country:US
Mailing Address - Phone:720-427-7807
Mailing Address - Fax:
Practice Address - Street 1:9527 PEARL CIR UNIT 202
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4205
Practice Address - Country:US
Practice Address - Phone:720-427-7807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic