| Montrose Wellness Center Pc | |
|
224 S Nevada Ave Montrose CO 81401-4234 | |
| (970) 252-9644 | |
| (970) 252-9646 |
| Full Name | Montrose Wellness Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 224 S Nevada Ave, Montrose, Colorado |
| Authorized Official Name and Position | Gayle Frazzetta (OWNER) |
| Authorized Official Contact | 9702529644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montrose Wellness Center Pc Po Box 1664 Montrose CO 81402-1664 Ph: (970) 252-9644 | Montrose Wellness Center Pc 224 S Nevada Ave Montrose CO 81401-4234 Ph: (970) 252-9644 |
| NPI Number | 1194728444 |
|---|---|
| Provider Enumeration Date | 05/31/2005 |
| Last Update Date | 10/04/2013 |
| Medicare PECOS PAC ID | 7416930755 |
|---|---|
| Medicare Enrollment ID | O20040609000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194728444 | NPI | - | NPPES |
| 04023917 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 32730 (Colorado) | Primary |
| Provider Name | Gayle A Frazzetta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184627432 PECOS PAC ID: 5294718532 Enrollment ID: I20100419000545 |
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