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General NPI Number Information
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NPI Number | 1457588568
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Entity Type | Organization
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Legal Business Name | A WOMAN'S HEALING CENTER, LLC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 1006 LUKE ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-4016
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Country | US
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Telephone | 970-419-1111
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Fax | 970-407-0001
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Provider Business Mailing Address
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Address Line | 1006 LUKE ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-4016
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Country | US
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Telephone | 970-419-1111
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Fax | 970-407-0001
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. AMANDA HILGENDORF
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Credential |
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Telephone | 970-419-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 37957
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License Number State | CO
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