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Organization
PUEBLO VASCULAR DIAGNOSTICS, INC
Active
Organization
PUEBLO VASCULAR DIAGNOSTICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARI A MCWHIRTER (OWNER)
(505) 419-0685
Entity
Organization
Contact information
Practice address
1619 N GREENWOOD ST STE 318, PUEBLO, CO 81003-2644
(716) 545-1607
Mailing address
PO BOX 479, PUEBLO, CO 81002-0479
(719) 545-1607
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63281279
—
CO
01
—
PU660277
BLUE CROSS BLUE SHIELD
CO
Enumeration date
05/24/2007
Last updated
08/22/2020
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