Provider Demographics
NPI:1578854352
Name:MOUNTAIN VIEW PLASTIC SURGERY PC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW PLASTIC SURGERY PC
Other - Org Name:MOUNTAIN VISTA PLASTIC SURGERY PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:H
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-226-0456
Mailing Address - Street 1:2020 LOWE ST
Mailing Address - Street 2:STE 202
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3606
Mailing Address - Country:US
Mailing Address - Phone:970-266-0456
Mailing Address - Fax:970-266-8733
Practice Address - Street 1:2020 LOWE ST
Practice Address - Street 2:STE 202
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3606
Practice Address - Country:US
Practice Address - Phone:970-266-0456
Practice Address - Fax:970-266-8733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty