Individual
LORI L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9285 HEPBURN ST, HIGHLANDS RANCH, CO 80129-2262
(303) 904-0121
Mailing address
9285 HEPBURN ST, HIGHLANDS RANCH, CO 80129-2262
(303) 904-0121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
116854
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016554
KAISER-COMMERCIAL NUMBER
—
Enumeration date
03/07/2007
Last updated
07/08/2007
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