| Wild Nature Wellness | |
|
124 Main St Suite # 305 Dillon CO 80435 | |
| (603) 455-8287 | |
| Not Available |
| Full Name | Wild Nature Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 124 Main St, Dillon, Colorado |
| Authorized Official Name and Position | Kristen Kelly Greenwald (OWNER) |
| Authorized Official Contact | 6034558287 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Nature Wellness Po Box 3272 Dillon CO 80435-3272 Ph: (603) 455-8287 | Wild Nature Wellness 124 Main St Suite # 305 Dillon CO 80435 Ph: (603) 455-8287 |
| NPI Number | 1043839665 |
|---|---|
| Provider Enumeration Date | 04/14/2020 |
| Last Update Date | 04/14/2020 |
| Certification Date | 04/14/2020 |
| Medicare PECOS PAC ID | 1658702071 |
|---|---|
| Medicare Enrollment ID | O20200519000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043839665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristen Kelly Greenwald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487010682 PECOS PAC ID: 2062842313 Enrollment ID: I20200429000051 |
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