Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 52421 | CO |
NPI | 1902069545 |
---|---|
Provider Name | Dr. Michele Angelec Streeter |
First Address | Salida, CO 81201-0429 |
Second Address | Salida, CO 81201-9627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 11/02/2021 |