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Individual

MRS. SOPHIA WAGNER BURGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1800 15TH ST STE 340, GREELEY, CO 80631-4562
(970) 810-4593
(970) 810-4591
Mailing address
1800 15TH ST STE 340, GREELEY, CO 80631-4562
(970) 810-4593
(970) 810-4591

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.0005117
CO
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
07/19/2017
Last updated
08/23/2021
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