| Family Medical Practice | |
|
2918 W 10th St Greeley CO 80634-5457 | |
| (970) 352-3274 | |
| (970) 352-3279 |
| Full Name | Family Medical Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 2918 W 10th St, Greeley, Colorado |
| Authorized Official Name and Position | Charles David Manter (OWNER) |
| Authorized Official Contact | 9703523274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Practice 2918 W 10th St Greeley CO 80634-5457 Ph: (970) 352-3274 | Family Medical Practice 2918 W 10th St Greeley CO 80634-5457 Ph: (970) 352-3274 |
| NPI Number | 1457531808 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 09/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457531808 | NPI | - | NPPES |
| 00522830 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 30988 (Colorado) | Primary |
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