MEDICARE: PERRY L TODD

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	171WH0202X	Home Modifications Contractor	C1-177	CO

General Provider Information

NPI Number	:	1831918028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERRY L TODD

Provider Business Mailing Address
First Line	:	231 S WHITCOMB ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2774
Country	:	US
Telephone Number	:	970-204-4535
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 S WHITCOMB ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2774
Country	:	US
Telephone Number	:	970-204-4535
Fax Number	:

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

Provider Enumeration Date	:	10/07/2024
Last Update Date	:	10/07/2024

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Directions to “ PERRY L TODD ” Practice Location

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