MEDICARE: COIRE JAMES WALKER

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1710624911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COIRE JAMES WALKER

Provider Business Mailing Address
First Line	:	4856 INNOVATION DR STE B
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-5540
Country	:	US
Telephone Number	:	970-494-4200
Fax Number	:	970-613-4475

Provider Business Practice Location Address
First Line	:	5080 FOSSIL BLVD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-4034
Country	:	US
Telephone Number	:	970-494-4200
Fax Number	:	970-613-4475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2022
Last Update Date	:	05/18/2022

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