Individual
KURT DOUGLAS NOTEBOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
80 HEALTH PARK DR, #230, LOUISVILLE, CO 80027-9584
(303) 665-2603
(303) 665-2605
Mailing address
8426 ZINNIA CT, ARVADA, CO 80005-1100
(303) 952-9926
(303) 436-3054
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10057
MN
363A00000X
Physician Assistant
Primary
738
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322152100
—
MN
Enumeration date
08/24/2006
Last updated
01/15/2008
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