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Organization

FRONT RANGE ENT, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LORI L MALONE (PRACTICE ADMINISTRATOR)
(970) 584-1063
Entity
Organization

Contact information

Practice address
6500 29TH STREET, SUITE 106, GREELEY, CO 80634-8386
(970) 330-5555
Mailing address
6500 29TH STREET, SUITE 106, GREELEY, CO 80634-8386
(970) 330-5555

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
41311
CO

Other

Enumeration date
01/20/2009
Last updated
10/31/2011
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