Provider Demographics
NPI:1669293619
Name:KLARISANA PHYSICIAN SERVICES PLLC
Entity type:Organization
Organization Name:KLARISANA PHYSICIAN SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-455-2747
Mailing Address - Street 1:8670 WOLFF CT STE 270
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6956
Mailing Address - Country:US
Mailing Address - Phone:844-455-2747
Mailing Address - Fax:888-504-2390
Practice Address - Street 1:6650 S VINE ST STE 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-2740
Practice Address - Country:US
Practice Address - Phone:844-455-2747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KLARISANA PHYSICIAN SERVICES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty