# WESTERN OTOLARYNGOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093986986
- **Authorized official:** CARLA FETZER (OFFICE MANAGER)
- **Authorized official phone:** (303) 425-0449

## Contact information

- **Practice address:** 3550 LUTHERAN PKWY W, STE 102, WHEAT RIDGE, CO 80033-6013
- **Practice address phone:** (303) 425-0449
- **Mailing address:** 3550 LUTHERAN PKWY W, STE 102 B, WHEAT RIDGE, CO 80033-6013
- **Mailing address phone:** (303) 425-0449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 19871416289 | CO | Yes |

## Other

- **Enumeration date:** 03/18/2008
- **Last updated:** 06/23/2009