Colorado River Primary Care, INC

NPI #1669146536 in Fort Mohave, Arizona

Provider Information

NPI Number: 1669146536
Entity Type: Organization
Organization Name: Colorado River Primary Care, INC
Primary Specialty: Internal Medicine
Enumeration Date: Aug 4, 2021
Last Updated: Mar 4, 2024

Practice Location

Address: 1510 E WAGON WHEEL LN STE 104
City: Fort Mohave
State: Arizona
ZIP Code: 86426-6698
Phone: (928) 248-0518

Authorized Official

Name: WANTZY COOPER, DO
Title: PRESIDENT
Phone: (928) 248-0518

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X
Internal Medicine	207R00000X	Primary

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