Individual
PAUL T BRUSASCHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524
(970) 495-7000
(303) 306-7753
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA.0005783
CO
207P00000X
Emergency Medicine Physician
PA18072
CA
363A00000X
Physician Assistant
Primary
PA.0005783
CO
Other
Enumeration date
06/30/2006
Last updated
07/24/2019
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