ROZELLA REBECCA CLARK

FORT COLLINS, CO
NPI1790829224
Professional NameROZELLA REBECCA CLARK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CO  PA.0004163)
Additional Taxonomies363A00000X Physician Assistant
(Licence: GA  5221)
363A00000X Physician Assistant
(Licence: NV  PA1380)
Enumeration Date2007-02-17
Last Update Date2015-11-19
Business Address
-- ROZELLA REBECCA CLARK
1024 S LEMAY AVE
FORT COLLINS, CO 80524-3929
Phone number: 970-495-7000
Mailing Address
-- ROZELLA REBECCA CLARK
PO BOX 912215
DENVER, CO 80291-2215
Phone number: 303-306-7101