Individual
DR. MARYJANE WEIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1625 TICONDEROGA DR, FORT COLLINS, CO 80525-3454
(970) 377-1090
(970) 493-9309
Mailing address
1625 TICONDEROGA DR, FORT COLLINS, CO 80525-3454
(970) 377-1090
(970) 493-9309
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2460
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
486668
MEDICARE GROUP
—
01
—
804282
MEDICARE #
—
Enumeration date
03/02/2008
Last updated
03/02/2008
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