Most Relevant Information
Provider Data
| NPI Number: | 1003690777 |
| Provider Name: | SOFIA MCILROY |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/23/2023 |
| Last Updated: | 08/23/2023 |
Provider Practice Location
1455 DIXON AVE
LAFAYETTE
CO
800268879
Practice Location Phone/Fax
| Phone: | 3034438500 |
| Fax: |
Provider Mailing Location
1455 DIXON AVE
LAFAYETTE
CO
800268879
Provider Mailing Phone/Fax
| Phone: | 3034438500 |
| Fax: |