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General NPI Number Information
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NPI Number | 1710189311
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Entity Type | Organization
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Legal Business Name | MESA COUNTY HEALTH DEPARTMENT
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 08/02/2007
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Provider Practice Location Address
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Address Line | 510 29.5 ROAD
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City | GRAND JUNCTION
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State | CO
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Zip | 81504
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Country | US
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Telephone | 970-683-6652
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Fax |
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Provider Business Mailing Address
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Address Line | 730 36 3/10 RD
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City | PALISADE
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State | CO
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Zip | 81526-9743
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Country | US
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Telephone | 970-250-8425
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAEL ADUDDELL
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Credential | M.D.
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Telephone | 970-248-6974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 175235
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License Number State | CO
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