Organization
WHOLENESS MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT SHANNON M.D. (OWNER/MEMBER)
(970) 221-1106
Entity
Organization
Contact information
Practice address
2620 E PROSPECT RD STE 190, FORT COLLINS, CO 80525-9098
(970) 221-1106
(970) 232-1050
Mailing address
2620 E PROSPECT RD STE 190, FORT COLLINS, CO 80525-9098
(970) 221-1106
(970) 232-1050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
31090
CO
207R00000X
Internal Medicine Physician
31090
CO
363AM0700X
Medical Physician Assistant
Primary
31090
CO
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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