Boulder Peak Family Practice, Inc. | |
5330 Manhattan Cir # C-2 Boulder CO 80303-4240 | |
(303) 543-1111 | |
(303) 543-1112 |
Full Name | Boulder Peak Family Practice, Inc. |
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Speciality | Family Medicine |
Location | 5330 Manhattan Cir # C-2, Boulder, Colorado |
Authorized Official Name and Position | Mark A. Wisner (PRESIDENT) |
Authorized Official Contact | 3035431111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Boulder Peak Family Practice, Inc. 5330 Manhattan Cir # C-2 Boulder CO 80303-4240 Ph: (303) 543-1111 | Boulder Peak Family Practice, Inc. 5330 Manhattan Cir # C-2 Boulder CO 80303-4240 Ph: (303) 543-1111 |
NPI Number | 1669705042 |
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Provider Enumeration Date | 09/16/2009 |
Last Update Date | 09/16/2009 |
Identifier | Type | State | Issuer |
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1669705042 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 44052 (Colorado) | Primary |
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