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Individual

MARY LAUDERDALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1313 RIVERSIDE AVE, FORT COLLINS, CO 80524-4352
(970) 493-1292
(970) 493-1210
Mailing address
1313 RIVERSIDE AVE, FORT COLLINS, CO 80524-4352
(970) 493-1292
(970) 493-1210

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
117108
CO

Other

Enumeration date
03/01/2016
Last updated
03/01/2016
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