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Individual

MR. TAE S FUGATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AAS

Contact information

Practice address
1745 CATNAP LN, MONUMENT, CO 80132-6127
(719) 888-1007
(719) 487-2689
Mailing address
PO BOX 1945, COLORADO SPRINGS, CO 80901-1945
(719) 338-6715
(719) 487-2689

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary

Other

Enumeration date
03/22/2007
Last updated
07/07/2022
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