Individual
TERRA LYNN BOOKOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
125 INVERNESS DR E, SUITE 240, ENGLEWOOD, CO 80112-5137
(720) 863-1004
Mailing address
2416 BLACK DUCK AVE., JOHNSTOWN, CO 80534
(970) 231-5441
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3458
CO
Other
Enumeration date
12/08/2012
Last updated
12/08/2012
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