Organization
FAMILY AND SPORTS MEDICINE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIAN ROBERT GERSHON JR. DO (OWNER)
(970) 243-8524
Entity
Organization
Contact information
Practice address
321 ROOD AVE, GRAND JUNCTION, CO 81501-2451
(970) 243-8524
(970) 263-8427
Mailing address
321 ROOD AVE, GRAND JUNCTION, CO 81501-2451
(970) 243-8524
(970) 263-8427
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06386261
—
CO
Enumeration date
09/08/2008
Last updated
03/28/2014
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