Individual
LINDA S GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2525 13TH STREET, BOULDER, CO 80304-4104
(303) 449-6050
Mailing address
1345 PLAZA CT N STE 1A, LAFAYETTE, CO 80026-2832
(303) 665-3036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
98
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51804221
—
CO
Enumeration date
10/10/2005
Last updated
07/17/2013
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