| Fredrick C. Widman | |
|
11160 Huron St Ste 32 Northglenn CO 80234-3335 | |
| (720) 510-9115 | |
| Not Available |
| Full Name | Fredrick C. Widman |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 11160 Huron St Ste 32, Northglenn, Colorado |
| Authorized Official Name and Position | Penny Widman (OFFICE MANAGER) |
| Authorized Official Contact | 3033454568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fredrick C. Widman 2930 Madison Ln Broomfield CO 80023-4522 Ph: (303) 345-4568 | Fredrick C. Widman 11160 Huron St Ste 32 Northglenn CO 80234-3335 Ph: (720) 510-9115 |
| NPI Number | 1821875600 |
|---|---|
| Provider Enumeration Date | 09/13/2023 |
| Last Update Date | 09/13/2023 |
| Certification Date | 09/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821875600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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