Individual
TERRY VILLARREAL-GOLBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
281 N PLUM ST, FRUITA, CO 81521-2100
(970) 858-9894
(970) 858-1331
Mailing address
PO BOX 130, FRUITA, CO 81521-0130
(970) 858-9894
(970) 858-1331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0001524
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37125541
—
CO
Enumeration date
05/09/2006
Last updated
04/16/2019
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