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General NPI Number Information
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NPI Number | 1811372113
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Entity Type | Organization
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Legal Business Name | GUNNISON PODIATRY LLC
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 711 N TAYLOR ST
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City | GUNNISON
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State | CO
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Zip | 81230-2243
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Country | US
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Telephone | 970-497-9932
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Fax | 970-465-7313
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Provider Business Mailing Address
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Address Line | 711 N TAYLOR ST
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City | GUNNISON
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State | CO
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Zip | 81230-2243
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Country | US
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Telephone | 970-497-9932
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Fax | 970-465-7313
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY ARTHUR OSTER
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Credential | DPM
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Telephone | 740-258-3825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 261QP1100X
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License Number State | CO
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