Organization
ENT CLINIC P.C.
Active
Other names
Alpha ENT Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA CONLON (PRACTICE ADMINISTRATOR)
(970) 484-8686
Entity
Organization
Contact information
Practice address
1032 LUKE ST, FORT COLLINS, CO 80524-4037
(970) 484-8686
(970) 484-1064
Mailing address
1032 LUKE ST, FORT COLLINS, CO 80524-4037
(970) 484-8686
(970) 484-1064
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04008512
—
CO
Enumeration date
02/20/2007
Last updated
12/03/2013
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