Organization
GREELEY XRAY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN FISCHER (OFFICE MANAGER)
(970) 381-8677
Entity
Organization
Contact information
Practice address
5890 W 13TH ST, SUITE 104, GREELEY, CO 80634-4821
(970) 392-5400
Mailing address
PO BOX 336940, GREELEY, CO 80633-0616
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04106084
—
CO
05
—
117621800
—
WY
01
—
G3008
BCBS
CO
Enumeration date
07/04/2006
Last updated
09/02/2008
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