Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Boulder Plastic Surgery Prof LLC

Organization Specialist · NPI 1114513009

Boulder Plastic Surgery Prof LLC is a Specialist in Longmont, Colorado. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1750 E Ken Pratt Blvd
Longmont, CO 80504-5311
Phone: (720) 718-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1114513009
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Pam Garcia — Office Contact · (303) 443-2277
NPI enumeratedDecember 15, 2020
Last updated in NPPESDecember 15, 2020
Certification dateDecember 15, 2020
Mailing addressPo Box 7643, Loveland, CO 80537-0643

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