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General NPI Number Information
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NPI Number | 1538338314
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Entity Type | Organization
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Legal Business Name | RALPH J WENTZ DPM PC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 920 RUSH DR
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City | SALIDA
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State | CO
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Zip | 81201-9669
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Country | US
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Telephone | 719-539-6600
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Fax | 719-539-6606
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Provider Business Mailing Address
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Address Line | PO BOX 456
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City | SALIDA
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State | CO
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Zip | 81201-0456
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Country | US
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Telephone | 719-539-6600
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Fax | 719-539-6606
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Authorized Official
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Title or Position | OWNER
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Name | DR. RALPH J WENTZ JR.
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Credential | DPM
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Telephone | 719-539-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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