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General NPI Number Information
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NPI Number | 1447498407
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Entity Type | Organization
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Legal Business Name | GREELEY MEDICAL CLINIC
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 1900 16TH ST
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City | GREELEY
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State | CO
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Zip | 80631-5114
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Country | US
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Telephone | 970-350-2423
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Fax | 970-350-2498
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Provider Business Mailing Address
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Address Line | 1900 16TH ST
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City | GREELEY
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State | CO
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Zip | 80631-5114
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Country | US
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Telephone | 970-350-2423
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Fax | 970-350-2498
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Authorized Official
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Title or Position | CFO
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Name | STEVEN SCHWARTZ
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Credential |
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Telephone | 970-350-2416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 1234
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License Number State | CO
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