Provider Demographics
NPI:1679165740
Name:IONM PHYSICIANS SERVICES, S.C.
Entity Type:Organization
Organization Name:IONM PHYSICIANS SERVICES, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-435-5129
Mailing Address - Street 1:4833 FRONT ST UNIT 406B
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7902
Mailing Address - Country:US
Mailing Address - Phone:720-435-5129
Mailing Address - Fax:
Practice Address - Street 1:1708 RIDGECREST
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-3160
Practice Address - Country:US
Practice Address - Phone:815-715-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty