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Individual

ALLISTER M BOUSTRED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2315 E HARMONY RD, SUITE 160, FORT COLLINS, CO 80528-8620
(970) 493-8800
(970) 498-8800
Mailing address
2315 E HARMONY RD, SUITE 160, FORT COLLINS, CO 80528-8620
(970) 493-8800
(970) 498-8800

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
45791
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
87736730
CO
Enumeration date
04/25/2006
Last updated
01/23/2009
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