Individual
LESLIE A STANWIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1413 N MILDRED RD, CORTEZ, CO 81321-2258
(970) 564-1037
(970) 564-1041
Mailing address
1413 N MILDRED RD, CORTEZ, CO 81321-2258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23422
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01234228
—
CO
Enumeration date
07/18/2006
Last updated
03/22/2021
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