Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 6326 | CO |
NPI | 1942441217 |
---|---|
Provider Name | Ryan C Weisgerber |
First Address | Fort Collins, CO 80526-5568 |
Second Address | Fort Collins, CO 80526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2009 |
Last Update Date | 30/10/2009 |