Healthcare Provider Details

I. General information

NPI: 1427328020
Provider Name (Legal Business Name): WOMB FOR GROWTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 MCCLELLAND DR STE 3600
FORT COLLINS CO
80525-2587
US

IV. Provider business mailing address

2850 MCCLELLAND DR STE 3600
FORT COLLINS CO
80525-2587
US

V. Phone/Fax

Practice location:
  • Phone: 970-224-2912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5250
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number5250
License Number StateCO

VIII. Authorized Official

Name: DR. COLLEEN MICHELE HOLLAND
Title or Position: OWNER
Credential: D.C.
Phone: 970-224-2912