Individual
DARRYL WILLIAM SANDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
HHC 1/2 AVIATION REGIMENT, AVIATION MEDICINE CLINIC BLDG 1058, FORT CARSON, CO 80913
(719) 526-8477
Mailing address
682 HIGH TEA CT, FOUNTAIN, CO 80817-4631
(970) 485-4377
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/24/2008
Last updated
03/22/2013
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