Organization
LARRY D. TICE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY D TICE MD (PRESIDENT)
(970) 858-2603
Entity
Organization
Contact information
Practice address
1120 WELLINGTON AVE, SUITE 206, GRAND JUNCTION, CO 81501-6129
(970) 241-8013
(970) 241-1308
Mailing address
551 KOKOPELLI BLVD, FRUITA, CO 81521-6305
(970) 858-2603
(970) 858-3211
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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