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Organization
DESERT RIVER DIRECT, PLLC
Active
Organization
DESERT RIVER DIRECT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA L ROBICHEAUX (BUSINESS MANAGER)
(719) 285-8890
Entity
Organization
Contact information
Practice address
1335 PHAY AVE STE A, CANON CITY, CO 81212-2349
(719) 285-8890
Mailing address
712 MACON AVE, CANON CITY, CO 81212-3314
(719) 285-8890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
05/05/2025
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