MEDICARE: COMPLETE WELLNESS FAMILLY MEDICINE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1003538240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE WELLNESS FAMILLY MEDICINE, PLLC

Provider Business Mailing Address
First Line	:	2625 REDWING RD STE 260
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6353
Country	:	US
Telephone Number	:	970-213-0378
Fax Number	:

Provider Business Practice Location Address
First Line	:	2627 REDWING RD STE 300
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6310
Country	:	US
Telephone Number	:	970-213-0378
Fax Number	:	970-672-8137

Authorized Official
Title or Position	:	OWNER
Name	:	KATHLEEN R MAGUIRE
Credential	:
Telephone Number	:	970-631-8650

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	03/14/2024

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