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General NPI Number Information
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NPI Number | 1750785036
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Entity Type | Organization
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Legal Business Name | PRACTICAL HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 310 E ELIZABETH ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-3706
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Country | US
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Telephone | 970-482-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 310 E ELIZABETH ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-3706
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Country | US
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Telephone | 970-482-2010
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Fax |
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Authorized Official
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Title or Position | OWNER, NATUROPATHIC DOCTOR
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Name | DR. JOAN DELYSE WATERS
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Credential | ND
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Telephone | 970-482-2010
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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 | ND.0000083
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License Number State | CO
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