Provider Demographics
NPI:1073968053
Name:RATHBUN, PAUL (BA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:RATHBUN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
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Mailing Address - Street 1:211 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3168
Mailing Address - Country:US
Mailing Address - Phone:970-522-4549
Mailing Address - Fax:970-522-6898
Practice Address - Street 1:821 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3365
Practice Address - Country:US
Practice Address - Phone:970-867-4924
Practice Address - Fax:970-867-4584
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)