Provider Demographics
NPI:1073998043
Name:SMITS, GREG (CO)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:SMITS
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 E PROSPECT RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-9768
Mailing Address - Country:US
Mailing Address - Phone:300-400-8866
Mailing Address - Fax:970-416-9359
Practice Address - Street 1:2290 E PROSPECT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-9768
Practice Address - Country:US
Practice Address - Phone:300-400-8866
Practice Address - Fax:970-416-9359
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist