Organization
WESTERN OTOLARYNGOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA FETZER (OFFICE MANAGER)
(303) 425-0449
Entity
Organization
Contact information
Practice address
3550 LUTHERAN PKWY W, STE 102, WHEAT RIDGE, CO 80033-6013
(303) 425-0449
Mailing address
3550 LUTHERAN PKWY W, STE 102 B, WHEAT RIDGE, CO 80033-6013
(303) 425-0449
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
19871416289
CO
Other
Enumeration date
03/18/2008
Last updated
06/23/2009
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