Healthcare Provider Details

I. General information

NPI: 1699757450
Provider Name (Legal Business Name): MONTROSE WOMENS HEALTH CARE, PC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 SOUTH 4TH STREET
MONTROSE CO
81401-4226
US

IV. Provider business mailing address

904 SOUTH 4TH STREET
MONTROSE CO
81401-4226
US

V. Phone/Fax

Practice location:
  • Phone: 970-252-3450
  • Fax: 970-252-3454
Mailing address:
  • Phone: 970-252-3450
  • Fax: 970-252-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number453168
License Number StateCO

VIII. Authorized Official

Name: JAMES H GARRARD
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 303-545-5525