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General NPI Number Information
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NPI Number | 1346863388
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Entity Type | Organization
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Legal Business Name | CATHY O'NEIL, MD, LCC
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 05/26/2020
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Provider Practice Location Address
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Address Line | 603 KEN PRATT BLVD
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City | LONGMONT
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State | CO
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Zip | 80501-6419
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Country | US
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Telephone | 303-501-6171
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Fax |
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Provider Business Mailing Address
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Address Line | 165 S PEARL ST
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City | DENVER
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State | CO
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Zip | 80209-2015
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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 | PRINCIPAL
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Name | CATHY O'NEIL
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Credential | MD
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Telephone | 303-501-6171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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