Individual
IAN WINGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
16477 HIGHWAY 144, FORT MORGAN, CO 80701-4814
(970) 380-4577
Mailing address
16477 HIGHWAY 144, FORT MORGAN, CO 80701-4814
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0014816
CO
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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