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Organization
PUEBLO WEST PRIMARY CARE LLC
Active
Organization
PUEBLO WEST PRIMARY CARE LLC
Active
Other names
Pueblo West Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI SHAWCROFT (OFFICE MANAGER)
(719) 251-9465
Entity
Organization
Contact information
Practice address
141 S PURCELL BLVD STE 140, PUEBLO WEST, CO 81007-5123
(719) 281-9587
(719) 960-2054
Mailing address
141 S PURCELL BLVD STE 140, PUEBLO WEST, CO 81007-5123
(719) 281-9587
(719) 960-2054
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
10/29/2019
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