Basic Information
| Provider Information | |||||||||
| NPI: | 1073768735 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINCHESTER | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | PEARCE | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3307 S COLLEGE AVE | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805254196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9704079999 | ||||||||
| FaxNumber: | 9702079844 | ||||||||
| Practice Location | |||||||||
| Address1: | 1446 HOVER RD | ||||||||
| Address2: | |||||||||
| City: | LONGMONT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805012485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037723300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2008 | ||||||||
| LastUpdateDate: | 11/22/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 156F00000X | Y | Eye and Vision Services Providers | Technician/Technologist |
No ID Information.