Individual
MS. ELLEN LOUISE BLACKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10900 SMITH RD, DENVER, CO 80239-3262
(303) 307-2320
Mailing address
PO BOX 1228, BOULDER, CO 80306-1228
(303) 473-4546
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
397
CO
Other
Enumeration date
11/23/2007
Last updated
11/23/2007
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