Individual
KYLE DELONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2373 G RD STE 200, GRAND JUNCTION, CO 81505-1006
(970) 243-3061
(970) 245-8369
Mailing address
2373 G RD STE 200, GRAND JUNCTION, CO 81505-1006
(970) 243-3061
(970) 245-8369
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.0004762
CO
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71585036
—
CO
Enumeration date
07/11/2016
Last updated
12/31/2018
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