Healthcare Provider Details

I. General information

NPI: 1336807932
Provider Name (Legal Business Name): WESTERN MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 HORIZON CT STE 100
GRAND JUNCTION CO
81506-8715
US

IV. Provider business mailing address

743 HORIZON CT STE 100
GRAND JUNCTION CO
81506-8715
US

V. Phone/Fax

Practice location:
  • Phone: 970-256-8504
  • Fax: 970-245-9094
Mailing address:
  • Phone: 970-256-8504
  • Fax: 970-245-9094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER L SLOAN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 970-256-8504