Healthcare Provider Details

I. General information

NPI: 1316929284
Provider Name (Legal Business Name): WESTERN COLORADO RADIOLOGIC ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 N 7TH ST
GRAND JUNCTION CO
81501-8209
US

IV. Provider business mailing address

2530 N 8TH ST 101
GRAND JUNCTION CO
81501-8857
US

V. Phone/Fax

Practice location:
  • Phone: 970-241-9729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHARLEE LEBLEU
Title or Position: VICE PRESIDENT
Credential:
Phone: 480-321-7026