Individual
LORETTA ANN VAN WYHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9950 N COUNTY ROAD 19, FORT COLLINS, CO 80524-9707
(970) 568-3635
Mailing address
9950 N COUNTY ROAD 19, FORT COLLINS, CO 80524-9707
(970) 568-3635
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
30257
CA
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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