Individual
JONATHAN EDMUNDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-5884
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 350-4602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0007141
CO
Other
Enumeration date
10/18/2021
Last updated
04/13/2022
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