Provider Demographics
NPI:1760505655
Name:WILLIAMS FREY PC
Entity Type:Organization
Organization Name:WILLIAMS FREY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-768-9393
Mailing Address - Street 1:156 HAYSTACK LN
Mailing Address - Street 2:
Mailing Address - City:SNOWMASS
Mailing Address - State:CO
Mailing Address - Zip Code:81654-9309
Mailing Address - Country:US
Mailing Address - Phone:970-927-0595
Mailing Address - Fax:
Practice Address - Street 1:319 ABC UNIT A
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-3516
Practice Address - Country:US
Practice Address - Phone:970-925-7844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC456018Medicare ID - Type UnspecifiedWILLIAMS FREY PC