Individual
MR. TERRY LEE EMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1600 N GRAND AVE STE 500, PUEBLO, CO 81003-2757
(719) 545-0663
(719) 595-7903
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4127
(970) 490-4173
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0001838
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61030325
—
CO
Enumeration date
05/22/2007
Last updated
10/31/2025
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