Individual
GARY PAUL MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 BALSAM AVENUE, BOULDER, CO 80304-3404
(303) 440-2037
(303) 306-7753
Mailing address
P.O. BOX 173894, DENVER, CO 80217-3894
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0002507
CO
363A00000X
Physician Assistant
PA2507
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32372736
—
CO
Enumeration date
10/09/2007
Last updated
01/13/2016
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