Organization
BARIATRIC AND LIFESTYLE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA J MCCANN (BILLING MANAGER)
(970) 980-6024
Entity
Organization
Contact information
Practice address
1939 WILMINGTON DR, SUITE 102, FORT COLLINS, CO 80528-6404
(970) 980-6024
(877) 489-6002
Mailing address
1939 WILMINGTON DR, SUITE 102, FORT COLLINS, CO 80528-6404
(970) 980-6024
(877) 489-6002
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
37885
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32801718
—
CO
Enumeration date
01/04/2011
Last updated
01/04/2011
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