Gustavson, John L

Gustavson, John L is an individual health care provider with primary practice located at 2530 N 8Th St Suite 204, Grand Junction CO 81501-8857. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Gustavson, John L can be contacted via phone (970) 245-3505.

Contact Information

Primary practice address
2530 N 8Th St Suite 204 Grand Junction CO 81501-8857
Phone: (970) 245-3505
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PSY.0000987 Colorado

Profile Details

NPI number 1720068059
LBN Legal business name Gustavson, John L
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Oct 30th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720068059 NPPES
Colorado MEDICAID 07987001

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