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General NPI Number Information
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NPI Number | 1497119515
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Entity Type | Organization
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Legal Business Name | WHOLE HEALTH FAMILY MEDICINE CLINIC, P.C.
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 555 RIVERGATE SUITE B1-102
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City | DURANGO
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State | CO
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Zip | 81301-7470
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Country | US
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Telephone | 970-259-1971
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Fax |
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Provider Business Mailing Address
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Address Line | 923 SUNDANCE CIR
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City | DURANGO
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State | CO
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Zip | 81303-8852
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Country | US
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Telephone | 970-946-3878
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Fax |
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Authorized Official
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Title or Position | OFFICE COORDINATOR
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Name | KARASSA YEOMANS SCHAEFER
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Credential | PAC
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Telephone | 970-259-1971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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