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General NPI Number Information
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NPI Number | 1255906541
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Entity Type | Organization
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Legal Business Name | CHILDREN'S WELLNESS CENTER OF COLORADO, PLLC
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 12150 E BRIARWOOD AVE UNIT 202
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City | CENTENNIAL
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State | CO
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Zip | 80112-6755
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Country | US
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Telephone | 720-662-7862
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Fax |
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Provider Business Mailing Address
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Address Line | 12150 E BRIARWOOD AVE UNIT 202
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City | CENTENNIAL
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State | CO
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Zip | 80112-6755
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COOWNER
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Name | CHRISTINE WERNER GARCIA
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Credential |
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Telephone | 720-662-7862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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