Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 34026 | CO |
NPI | 1205866837 |
---|---|
Provider Name | William A Lanting |
First Address | Fort Collins, CO 80524-3926 |
Second Address | Fort Collins, CO 80524-3926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 05/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01340264 | (05) | CO |
F95437 | (02) | CO |