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NPI Code Detail

MEDICARE: BRITTNY WOLDA

MEDICARE:   BRITTNY  WOLDA
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
1183500000XPharmacist20838CO

General Provider Information

NPI Number : 1811373616
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTNY WOLDA
Provider Business Mailing Address
First Line : 3130 MAIN AVE
Second Line :
City : DURANGO
State : CO
Zip : 81301-4247
Country : US
Telephone Number : 970-259-0240
Fax Number :
Provider Business Practice Location Address
First Line : 3130 MAIN AVE
Second Line :
City : DURANGO
State : CO
Zip : 81301-4247
Country : US
Telephone Number : 970-259-0240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2015
Last Update Date : 08/04/2015

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Directions to “ BRITTNY WOLDA ” Practice Location

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