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Organization

BOULDER PEAK FAMILY PRACTICE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK A. WISNER D.O. (PRESIDENT)
(303) 543-1111
Entity
Organization

Contact information

Practice address
5330 MANHATTAN CIR # C-2, BOULDER, CO 80303-4240
(303) 543-1111
(303) 543-1112
Mailing address
5330 MANHATTAN CIR # C-2, BOULDER, CO 80303-4240
(303) 543-1111
(303) 543-1112

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44052
CO

Other

Enumeration date
09/16/2009
Last updated
09/16/2009
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