Individual
MR. TYLEN JOE PAVLOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-3000
Mailing address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0007719
CO
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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