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General NPI Number Information
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NPI Number | 1609814284
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN FAMILY PRACTICE OF LEADVILLE PC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 735 US HIGHWAY 24
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City | LEADVILLE
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State | CO
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Zip | 80461-3978
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Country | US
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Telephone | 719-486-0500
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Fax | 719-486-3966
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Provider Business Mailing Address
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Address Line | 735 US HIGHWAY 24
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City | LEADVILLE
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State | CO
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Zip | 80461-3978
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Country | US
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Telephone | 719-486-0500
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Fax | 719-486-3966
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Authorized Official
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Title or Position | OWNER
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Name | LISA P. ZWERDLINGER
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Credential | M.D.
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Telephone | 719-486-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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