Organization
MOUNTAIN SURGICAL ASSOCIATES PC, LLC
Active
Organization
MOUNTAIN SURGICAL ASSOCIATES PC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC ANTHONY VETRI (MANAGING PARTNER)
(970) 799-1840
Entity
Organization
Contact information
Practice address
10 TOWN PLZ, SUITE 81, DURANGO, CO 81301-5104
(970) 799-1840
(970) 385-4350
Mailing address
10 TOWN PLZ, SUITE 81, DURANGO, CO 81301-5104
(970) 799-1840
(970) 385-4350
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA1741
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1741
COLORADO MEDICAL LICENSE
CO
Enumeration date
02/11/2009
Last updated
02/24/2009
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