Provider Demographics
NPI:1275722621
Name:CK LEASING, LLC
Entity Type:Organization
Organization Name:CK LEASING, LLC
Other - Org Name:ROCKY MOUNTAIN CYBERKNIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SPURLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-263-7844
Mailing Address - Street 1:905 ALPINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3305
Mailing Address - Country:US
Mailing Address - Phone:303-448-4620
Mailing Address - Fax:303-449-5807
Practice Address - Street 1:905 ALPINE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3305
Practice Address - Country:US
Practice Address - Phone:303-448-4620
Practice Address - Fax:303-449-5807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE32531Medicare UPIN