Individual
BETH PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
550 W HWY 50, SALIDA, CO 81201-2238
(719) 539-2048
(719) 539-2055
Mailing address
PO BOX 429, SALIDA, CO 81201-0429
(719) 530-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2953
AZ
363A00000X
Physician Assistant
Primary
PA-2578
CO
Other
Enumeration date
07/03/2006
Last updated
05/25/2021
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