Individual
DR. AMY MARIE LICHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
(970) 472-9381
Mailing address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
(970) 472-9381
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DR.0038886
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02330237
—
CO
05
—
115352800
—
WY
Enumeration date
10/06/2005
Last updated
06/07/2013
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