| Organization Name: | NCMC SPECIALTY CLINIC |
| NPI Number: | 1023319464 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENNIS E DAHLEN (SR VP FINANCE) |
| Mailing Address: | 1800 15th St Suite 320 Greeley |
| State: | CO US |
| Postal Code: | 806314500 |
| Phone Number: | 9703506953 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2010 |
| NPI Last Update Date: | 07/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |