Organization
COLORADO EAR, NOSE & THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK EDWARD HENDERSON D.O. (OWNER)
(970) 249-6968
Entity
Organization
Contact information
Practice address
156 COLORADO AVE, MONTROSE, CO 81401-3678
(970) 249-6968
(970) 240-4729
Mailing address
156 COLORADO AVE, MONTROSE, CO 81401-3678
(970) 249-6968
(970) 240-4729
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
31899
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01318997
—
CO
Enumeration date
11/09/2009
Last updated
11/09/2009
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