Individual
MICHAEL JOHN NOONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
95-A W. 1ST AVE., RIO GRANDE MEDICAL CENTER, MONTE VISTA, CO 81144
(719) 852-2512
Mailing address
223 STALLO ST, MONTE VISTA, CO 81144-1645
(719) 850-0613
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAL-2886
CO
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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