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Specialty details in registry · Evans, CO

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At a glance

3111 Tide Water Ct, Evans, CO 80620-9009

NPPES record updated Jun 10, 2026. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
  • Do I need a referral, and what is the earliest appointment?

Insurance participation and appointment availability are not established by these public records.

Practice location

3111 Tide Water Ct
Evans, CO 80620-9009

Additional reported practice locations

501 8Th Ave
Greeley, CO 806313913
Phone: 9708443128
Professional details: NPI, taxonomy & registry record
NPI1861261976
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
171W00000X
Enumeration date
Dec 29, 2023
Record updated
Jun 10, 2026
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

171W00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

3111 Tide Water Ct
Evans, CO 80620-9009
Phone
(970) 791-0474
Mailing address
3111 TIDE WATER CT

EVANS, CO 806209009
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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