Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 49228 | CO |
NPI | 1003080565 |
---|---|
Provider Name | Jessica A. Guiroy |
First Address | Fort Collins, CO 80525-5591 |
Second Address | Fort Collins, CO 80525-5591 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 04/10/2010 |