Individual
DR. INGERLISA WENCHE MATTOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1708 N. BOISE, LOVELAND, CO 80538-4204
(970) 818-6788
(970) 669-0159
Mailing address
PO BOX 7268, LOVELAND, CO 80537-0268
(970) 818-6788
(970) 669-0159
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
DR.0049136
CO
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
49136
CO
Other
Enumeration date
10/12/2007
Last updated
02/08/2021
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