Provider Demographics
NPI:1174649230
Name:ADVANCED FAMILY HEALTH PLLC
Entity Type:Organization
Organization Name:ADVANCED FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BULMAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-666-4949
Mailing Address - Street 1:325 W SOUTH BOULDER RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1159
Mailing Address - Country:US
Mailing Address - Phone:303-666-4949
Mailing Address - Fax:
Practice Address - Street 1:325 W SOUTH BOULDER RD
Practice Address - Street 2:SUITE #1
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1159
Practice Address - Country:US
Practice Address - Phone:303-666-6566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty