Individual
JULIE S EDMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(970) 495-7000
(970) 484-4759
Mailing address
2008 CARIBOU DR, FORT COLLINS, CO 80525-4325
(970) 484-4757
(970) 484-4759
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
LA#A10389
LA
363A00000X
Physician Assistant
Primary
PA.0006211
CO
Other
Enumeration date
11/22/2006
Last updated
09/11/2020
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