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General NPI Number Information
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NPI Number | 1699214130
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Entity Type | Organization
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Legal Business Name | WESTERN SLOPE FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 02/16/2017
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Last Update Date | 12/13/2017
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Provider Practice Location Address
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Address Line | 1804 E PAVILION PL
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City | MONTROSE
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State | CO
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Zip | 81401-5795
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Country | US
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Telephone | 970-249-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 1804 E PAVILION PL
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City | MONTROSE
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State | CO
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Zip | 81401-5795
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Country | US
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Telephone | 207-315-1595
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MISS CORENNA HOWARD
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Credential |
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Telephone | 207-315-1595
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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 | DR 0057738
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License Number State | CO
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