Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 3399 | CO |
NPI | 1992918395 |
---|---|
Provider Name | Dr. Richard Keith Mobus |
First Address | Denver, CO 80210-4133 |
Second Address | Denver, CO 80210-1583 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |