Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1241 | CO |
NPI | 1184813735 |
---|---|
Provider Name | Dr. William Stone Livermore |
First Address | Denver, CO 80231-3992 |
Second Address | Denver, CO 80231-3992 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2007 |
Last Update Date | 19/10/2007 |