Organization
DIABETES DYNAMICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESE ANTONELLI LANDIN MA, CDE (CERTIFIED DIABETES EDUCATOR)
(970) 390-8311
Entity
Organization
Contact information
Practice address
9 RT. LADYBELLE PL, BOX 5620, EAGLE, CO 81631-5620
(970) 390-8311
(970) 328-5497
Mailing address
BOX 5620, 9 RT. LADYBELLE PL, EAGLE, CO 81631-5620
(970) 390-8311
(970) 328-5497
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
09018253
CO
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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