Healthcare Provider Details
I. General information
NPI: 1942300074
Provider Name (Legal Business Name): THE WOMEN'S CENTRE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2006
Last Update Date: 06/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
715 S 3RD ST
MONTROSE CO
81401-4209
US
IV. Provider business mailing address
715 S 3RD ST
MONTROSE CO
81401-4209
US
V. Phone/Fax
- Phone: 970-249-6737
- Fax: 970-252-0112
- Phone: 970-249-6737
- Fax: 970-252-0112
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 28740 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
RICHARD
G
HANLEY
Title or Position: OWNER
Credential: MD
Phone: 970-249-6737