Healthcare Provider Details

I. General information

NPI: 1760505655
Provider Name (Legal Business Name): WILLIAMS FREY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 ABC UNIT A
ASPEN CO
81611-3516
US

IV. Provider business mailing address

156 HAYSTACK LN
SNOWMASS CO
81654-9309
US

V. Phone/Fax

Practice location:
  • Phone: 970-925-7844
  • Fax:
Mailing address:
  • Phone: 970-927-0595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5135
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. JOANNE HARRIS
Title or Position: BILLING MANAGER
Credential:
Phone: 303-768-9393