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Organization

FREDRICK C. WIDMAN

Active
Other names
Reliant Services LLC
Organization subpart
No

Provider details

NPI number
Authorized official
PENNY WIDMAN (OFFICE MANAGER)
(303) 345-4568
Entity
Organization

Contact information

Practice address
11160 HURON ST STE 32, NORTHGLENN, CO 80234-3335
(720) 510-9115
Mailing address
2930 MADISON LN, BROOMFIELD, CO 80023-4522
(303) 345-4568

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
09/13/2023
Last updated
09/13/2023
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