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General NPI Number Information
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NPI Number | 1003538240
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Entity Type | Organization
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Legal Business Name | COMPLETE WELLNESS FAMILLY MEDICINE, PLLC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 2627 REDWING RD STE 300
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City | FORT COLLINS
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State | CO
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Zip | 80526-6310
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Country | US
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Telephone | 970-213-0378
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Fax | 970-672-8137
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Provider Business Mailing Address
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Address Line | 2625 REDWING RD STE 260
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City | FORT COLLINS
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State | CO
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Zip | 80526-6353
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Country | US
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Telephone | 970-213-0378
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHLEEN R MAGUIRE
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Credential |
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Telephone | 970-631-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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