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General NPI Number Information
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NPI Number | 1245696376
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Entity Type | Organization
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Legal Business Name | ANFEALD LLC
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 320 E VINE DR SUITE 214
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City | FORT COLLINS
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State | CO
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Zip | 80524-2311
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Country | US
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Telephone | 970-372-1131
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Fax | 866-641-7229
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Provider Business Mailing Address
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Address Line | PO BOX 1937
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City | FORT COLLINS
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State | CO
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Zip | 80522-1937
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Country | US
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Telephone | 970-372-1131
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Fax | 866-641-7229
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Authorized Official
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Title or Position | VP/PRINCIPAL
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Name | ANDREW T TROCCOLI
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Credential |
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Telephone | 970-372-1131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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