Individual
ERIC GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2150 STADIUM DRIVE, BOULDER, CO 80309-4206
(303) 315-9900
(303) 315-9902
Mailing address
PO BOX 9049, BOULDER, CO 80301-9049
(303) 315-9900
(303) 315-9902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-021112
IL
225100000X
Physical Therapist
Primary
PTL.0018005
CO
Other
Enumeration date
08/21/2014
Last updated
09/29/2024
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