Organization
SOPRIS WOMEN'S CLINIC
Active
Organization
SOPRIS WOMEN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA TREADWAY CNM (OWNER, LLC)
(970) 355-9686
Entity
Organization
Contact information
Practice address
410 20TH ST, STE 102, GLENWOOD SPRINGS, CO 81601-4271
(970) 355-9686
Mailing address
410 20TH ST, STE 102, GLENWOOD SPRINGS, CO 81601-4271
(970) 355-9686
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
123427
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72057840
—
CO
Enumeration date
07/19/2011
Last updated
07/19/2011
Update your record
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