Provider Demographics
NPI:1891886503
Name:BLUNK, GARY LEE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:LEE
Last Name:BLUNK
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2373 G RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-9641
Mailing Address - Country:US
Mailing Address - Phone:970-243-3061
Mailing Address - Fax:970-245-8369
Practice Address - Street 1:2373 G RD
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-9641
Practice Address - Country:US
Practice Address - Phone:970-243-3061
Practice Address - Fax:970-245-8369
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-05-16
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Provider Licenses
StateLicense IDTaxonomies
CO1394363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical