# SOUTHERN COLORADO CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHERN COLORADO CLINIC PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619562824
- **Legal business name:** SOUTHERN COLORADO CLINIC PC
- **Authorized official:** JENNIFER ARELLANO (COO)
- **Authorized official phone:** (719) 553-1801

## Contact information

- **Practice address:** 4112 OUTLOOK BLVD STE 290, PUEBLO, CO 81008-1667
- **Practice address phone:** (719) 553-2235
- **Practice address fax:** (833) 916-2049
- **Mailing address:** PO BOX 9000, PUEBLO, CO 81008-9000
- **Mailing address phone:** (719) 553-2235
- **Mailing address fax:** (833) 916-2049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/09/2021
- **Last updated:** 12/05/2022