MEDICARE: MICHAEL WOONTNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZB0500X	Biochemist

General Provider Information

NPI Number	:	1598299794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL WOONTNER

Provider Business Mailing Address
First Line	:	13123 E 16TH AVE # B120
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-7106
Country	:	US
Telephone Number	:	720-777-0506
Fax Number	:	720-777-7877

Provider Business Practice Location Address
First Line	:	13123 E 16TH AVE # B120
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-7106
Country	:	US
Telephone Number	:	720-777-0506
Fax Number	:	720-777-7877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2017
Last Update Date	:	04/13/2017

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Directions to “ MICHAEL WOONTNER ” Practice Location

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