Individual
GABRIEL HOLLIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1360 S POTOMAC ST, AURORA, CO 80012-4505
(303) 337-5575
Mailing address
1360 S POTOMAC ST, AURORA, CO 80012-4505
(303) 337-5575
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.000521
COLORADO MEDICAL BOARD
CO
Enumeration date
12/04/2017
Last updated
12/04/2017
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