Individual
LILA A STATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
235 W FLETCHER, HAXTUN, CO 80731-2737
(970) 774-6187
Mailing address
235 W FLETCHER, HAXTUN, CO 80731-2737
(970) 774-6187
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CO39171
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57002843
—
CO
Enumeration date
06/06/2006
Last updated
04/10/2012
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