VIRGINIA CARYL MACK

FORT COLLINS, CO
NPI1548552904
Former NameVIRGINIA CARYL OTTO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CO  APN0990068-NP)
Additional Taxonomies363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CO  NP990068)
Enumeration Date2011-05-04
Last Update Date2020-07-24
Business Address
Mrs. VIRGINIA CARYL MACK NP
CIRQUE MEADOW PSYCHIATRY 211 WEST MYRTE STREET, SUITE 207
FORT COLLINS, CO 80521-2971
Phone number: 360-621-1409
Mailing Address
Mrs. VIRGINIA CARYL MACK NP
VIRGINIA C MACK 415 S. WASHINGTON AVENUE
FORT COLLINS, CO 80521-2571
Phone number: 360-621-1409