Healthcare Provider Details

I. General information

NPI: 1831528397
Provider Name (Legal Business Name): ALEXANDER ESPINOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W MAIN ST
STERLING CO
80751-3168
US

IV. Provider business mailing address

211 W MAIN ST
STERLING CO
80751-3168
US

V. Phone/Fax

Practice location:
  • Phone: 970-522-4549
  • Fax: 970-522-6898
Mailing address:
  • Phone: 970-522-4549
  • Fax: 970-522-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: