Individual
SUSAN PUCKETT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2750 BROADWAY ST, BOULDER, CO 80304-3573
(303) 440-3000
Mailing address
2750 BROADWAY ST, BOULDER, CO 80304-3573
(303) 440-3073
(303) 440-3170
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
954
CO
Other
Enumeration date
12/08/2005
Last updated
04/15/2021
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