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Individual

MRS. TRACI WILKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3726 S TIMBERLINE RD, FORT COLLINS, CO 80525-4331
(970) 221-5795
(970) 221-1371
Mailing address
3726 S TIMBERLINE RD, FORT COLLINS, CO 80525-4331
(970) 221-5795
(970) 221-1371

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0003504
CO
363A00000X
Physician Assistant
PA16810
CA

Other

Enumeration date
05/14/2012
Last updated
09/17/2012
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