Organization
CHAYJAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY S WADE DO (PHYSICIAN)
(970) 249-2118
Entity
Organization
Contact information
Practice address
836 S TOWNSEND AVE STE C, MONTROSE, CO 81401-4360
(970) 249-2118
(970) 249-2187
Mailing address
836 S TOWNSEND AVE, UNIT C, MONTROSE, CO 81413
(970) 249-2118
(970) 249-2187
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78884284
—
CO
Enumeration date
02/04/2010
Last updated
09/22/2010
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