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General NPI Number Information
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NPI Number | 1447392543
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Entity Type | Individual
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Provider Name | JANE L WOLFORD OD
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 800 3RD AVE
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City | LONGMONT
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State | CO
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Zip | 80501-5928
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Country | US
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Telephone | 303-772-6140
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Fax | 303-772-9128
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Provider Business Mailing Address
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Address Line | 800 3RD AVE
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City | LONGMONT
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State | CO
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Zip | 80501-5928
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Country | US
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Telephone | 303-772-6140
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Fax | 303-772-9128
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1193
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License Number State | CO
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