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Individual

SUSAN MARIE WCISLAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2121 E HARMONY RD STE 2200, FORT COLLINS, CO 80528-3400
(970) 482-6456
(970) 482-3921
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-2409
(970) 490-4155

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35.135605
OH
208600000X
Surgery Physician
60454
AZ
208600000X
Surgery Physician
Primary
DR.0071443
CO

Other

Enumeration date
05/01/2014
Last updated
08/22/2023
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