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Individual

ROBERT LEE FENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1650 COCHRANE CIR # B7500, FT CARSON, CO 80913-4613
(334) 447-3714
Mailing address
1650 COCHRANE CIR # B7500, FT CARSON, CO 80913-4613
(334) 447-3714

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1169326
CO

Other

Enumeration date
03/03/2020
Last updated
03/09/2020
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