Provider Demographics
NPI:1497119515
Name:WHOLE HEALTH FAMILY MEDICINE CLINIC, P.C.
Entity Type:Organization
Organization Name:WHOLE HEALTH FAMILY MEDICINE CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARASSA
Authorized Official - Middle Name:
Authorized Official - Last Name:YEOMANS SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:970-259-1971
Mailing Address - Street 1:923 SUNDANCE CIR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-8852
Mailing Address - Country:US
Mailing Address - Phone:970-946-3878
Mailing Address - Fax:
Practice Address - Street 1:555 RIVERGATE
Practice Address - Street 2:SUITE B1-102
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7470
Practice Address - Country:US
Practice Address - Phone:970-259-1971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center