Individual
GARY M ATHERHOLT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPA-C, BSRT(R)
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10216
AZ
363A00000X
Physician Assistant
Primary
5161
CO
363AM0700X
Medical Physician Assistant
MA056314
PA
Other
Enumeration date
10/30/2012
Last updated
01/14/2026
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