Pvhs-Icm Health and Wellness, LLC

NPI #1023562030 in Fort Collins, Colorado

Provider Information

NPI Number: 1023562030
Entity Type: Organization
Organization Name: Pvhs-Icm Health and Wellness, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Aug 8, 2016
Last Updated: Aug 8, 2016

Practice Location

Address: 3702 AUTOMATION WAY
Address 2: SUITE 103
City: Fort Collins
State: Colorado
ZIP Code: 80525-5737
Phone: (970) 495-6201

Authorized Official

Name: DR. JAMES SPROWELL, MD
Title: MD
Phone: (970) 495-6201

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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