Individual
MICHELLE GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 E ELIZABETH ST STE 2, FORT COLLINS, CO 80524-4044
(970) 493-9193
Mailing address
14549 E 26TH AVE, AURORA, CO 80011-2404
(720) 849-9070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006856
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/19/2021
Last updated
07/01/2021
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