Individual
MASON WIEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 E ELIZABETH ST, FORT COLLINS, CO 80524-4007
(970) 267-9510
Mailing address
4385 E FLORIDA AVE, DENVER, CO 80222-3615
(970) 692-9885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
CO
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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