Individual
ERNIE STANLEY BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1644 S COLLEGE AVE, FORT COLLINS, CO 80525-1007
(970) 221-0999
(970) 221-2727
Mailing address
1644 S COLLEGE AVE, FORT COLLINS, CO 80525-1007
(970) 221-0999
(970) 221-2727
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
0499136
CO
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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