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General NPI Number Information
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NPI Number | 1053423186
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Entity Type | Organization
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Legal Business Name | NORTH COLORADO EAR NOSE & THROAT
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 2528 16TH ST
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City | GREELEY
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State | CO
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Zip | 80634-4955
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Country | US
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Telephone | 970-356-4646
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Fax | 970-356-2041
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | KERSEY
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State | CO
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Zip | 80644
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Country | US
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Telephone | 970-356-4646
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Fax | 970-356-2041
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JULIE M REINERT
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Credential |
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Telephone | 970-356-4646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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