NPI 1407272974

Jon Montgomery Gustafson, DVM

Practitioner Veterinarian Boulder, CO

Practice location

Address: 4636 55th St, Boulder, CO 80301-3005
Phone: (303) 530-2500
Fax: (303) 530-2885

Registered specialties

Veterinarian Primary

Other Service Providers Taxonomy 174M00000X Licence 3822 (CO)

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Registry record

NPI: 1407272974
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Mar 2014
Record last updated: 8 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.