| The Wish Clinic | |
|
4045 Wadsworth Blvd Ste 10 Wheat Ridge CO 80033-4625 | |
| (303) 940-1611 | |
| (303) 432-2296 |
| Full Name | The Wish Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4045 Wadsworth Blvd Ste 10, Wheat Ridge, Colorado |
| Authorized Official Name and Position | Traci A. Kimball (OWNER, PHYSICIAN) |
| Authorized Official Contact | 7205576510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Wish Clinic Po Box 21150 Boulder CO 80308-4150 Ph: (303) 940-1611 | The Wish Clinic 4045 Wadsworth Blvd Ste 10 Wheat Ridge CO 80033-4625 Ph: (303) 940-1611 |
| NPI Number | 1174305601 |
|---|---|
| Provider Enumeration Date | 10/18/2023 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174305601 | NPI | - | NPPES |
| 9000223352 | Medicaid | CO |
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