Provider Demographics
NPI:1750689634
Name:WOMENS HEALTH AND WELLNESS OF SALIDA
Entity Type:Organization
Organization Name:WOMENS HEALTH AND WELLNESS OF SALIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-593-9100
Mailing Address - Street 1:123 G ST
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-2030
Mailing Address - Country:US
Mailing Address - Phone:719-539-9100
Mailing Address - Fax:719-539-9200
Practice Address - Street 1:123 G ST
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2030
Practice Address - Country:US
Practice Address - Phone:719-539-9100
Practice Address - Fax:719-539-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46723207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty