Individual
THANYA JISSEL GUTIERREZ CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
181 W MEADOW DR STE 400, VAIL, CO 81657-5058
(970) 476-1100
Mailing address
62 STILLWATER, EDWARDS, CO 81632-7909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0009412
CO
Other
Enumeration date
05/21/2024
Last updated
11/18/2025
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