Renew Dermatology

LBN: Destination Dermatology Llc
Renew Dermatology is an health care organization with primary practice located at 60 Main Street Ste F, G & H, Frisco CO 80443. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Destination Dermatology Llc can be contacted via phone (309) 287-1909, or through Ballou, Kelly via phone (309) 287-1909.

Contact Information

Primary practice address
60 Main Street Ste F, G & H Frisco CO 80443
Phone: (309) 287-1909
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ballou, Kelly Physician's Assistant Certified (PA-C)
Phone: (309) 287-1909

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X PA0004388 Colorado

Profile Details

NPI number 1205368453
LBN Legal business name Destination Dermatology Llc
DBA Doing business as Renew Dermatology
Authorized official Ballou, Kelly Physician's Assistant Certified (PA-C)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 28th, 2017
Last updated Mar 28th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers