Boulder Peak Family Practice, Inc.

NPI #1669705042 in Boulder, Colorado

Provider Information

NPI Number: 1669705042
Entity Type: Organization
Organization Name: Boulder Peak Family Practice, Inc.
Primary Specialty: Family Medicine
Enumeration Date: Sep 16, 2009
Last Updated: Sep 16, 2009

Practice Location

Address: 5330 MANHATTAN CIR # C-2
City: Boulder
State: Colorado
ZIP Code: 80303-4240
Phone: (303) 543-1111

Authorized Official

Name: DR. MARK A. WISNER, D.O.
Title: PRESIDENT
Phone: (303) 543-1111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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