Individual
CHARLES GAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 E ELIZABETH ST STE F101, FORT COLLINS, CO 80524-4044
(970) 221-1177
Mailing address
15730 SW MISTY CT, BEAVERTON, OR 97007-4924
(970) 691-7924
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0070200
CO
Other
Enumeration date
11/22/2016
Last updated
08/04/2023
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