Organization
FIRST SIP LACTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE WYMAN IBCLC (AUTHORIZED OFFICIAL)
(702) 629-0991
Entity
Organization
Contact information
Practice address
13 PARAMOUNT PKWY, WHEAT RIDGE, CO 80215-6615
(702) 629-0991
Mailing address
13 PARAMOUNT PKWY, WHEAT RIDGE, CO 80215-6615
(702) 629-0991
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
07/15/2026
Last updated
07/15/2026
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