Individual
GREGORY A FRESHWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
710 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6123
(970) 298-7106
(970) 298-7177
Mailing address
710 WELLINGTON AVE, PO BOX 62, GRAND JUNCTION, CO 81501-6123
(970) 298-7106
(970) 298-7177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2205
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02589737
—
CO
Enumeration date
10/23/2006
Last updated
04/04/2011
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