Healthcare Provider Details

I. General information

NPI: 1710182084
Provider Name (Legal Business Name): GARY B MORSCH MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 EAGLE CREST DR
RANGELY CO
81648-3105
US

IV. Provider business mailing address

511 S WHITE AVE
RANGELY CO
81648-2100
US

V. Phone/Fax

Practice location:
  • Phone: 970-675-5011
  • Fax:
Mailing address:
  • Phone: 970-675-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: KYLE WREN
Title or Position: CEO
Credential:
Phone: 970-675-5011