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Organization
MAGNOLIA MEDICAL AESTHETICS, PLLC
Active
Organization
MAGNOLIA MEDICAL AESTHETICS, PLLC
Active
Other names
Pueblo Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RONDA ORNDOFF DNP (OWNER/PROVIDER)
(719) 250-9412
Entity
Organization
Contact information
Practice address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 250-9412
Mailing address
1478 43RD LN, PUEBLO, CO 81006-9307
(719) 250-9412
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
02/28/2025
Last updated
06/12/2025
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