| Dennis L Wack Ph.d Llc | |
|
4045 Wadsworth Blvd Suite 308 Wheat Ridge CO 80033-4642 | |
| (303) 421-1896 | |
| (303) 237-3589 |
| Full Name | Dennis L Wack Ph.d Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4045 Wadsworth Blvd, Wheat Ridge, Colorado |
| Authorized Official Name and Position | Dennis L Wack (PRESIDENT) |
| Authorized Official Contact | 3034211896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis L Wack Ph.d Llc 4045 Wadsworth Blvd Suite 308 Wheat Ridge CO 80033-4642 Ph: (303) 421-1896 | Dennis L Wack Ph.d Llc 4045 Wadsworth Blvd Suite 308 Wheat Ridge CO 80033-4642 Ph: (303) 421-1896 |
| NPI Number | 1366642092 |
|---|---|
| Provider Enumeration Date | 07/20/2007 |
| Last Update Date | 07/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366642092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1083 (Colorado) | Primary |
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