Individual
PATRICK ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2577 MAIN AVE, DURANGO, CO 81301-5919
(970) 247-8382
(970) 259-4403
Mailing address
2577 MAIN AVE, DURANGO, CO 81301-5919
(970) 247-8382
(970) 259-4403
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1474
ME
363AM0700X
Medical Physician Assistant
Primary
PA.0007052
CO
Other
Enumeration date
08/04/2014
Last updated
02/16/2022
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