MEDICARE: A CENTER FOR WOMEN'S CARE PC

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	207V00000X	Obstetrics & Gynecology Physician	43197	CO

General Provider Information

NPI Number	:	1033412838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A CENTER FOR WOMEN'S CARE PC

Provider Business Mailing Address
First Line	:	2001 BLAKE AVE SUITE 1A
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-4269
Country	:	US
Telephone Number	:	970-384-2000
Fax Number	:	970-384-2211

Provider Business Practice Location Address
First Line	:	2001 BLAKE AVE STE 1A
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-4269
Country	:	US
Telephone Number	:	970-384-2000
Fax Number	:	970-384-2211

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CYNTHIA L HALL
Credential	:	DO
Telephone Number	:	970-384-2000

Provider Enumeration Date	:	12/16/2010
Last Update Date	:	12/16/2010

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