Organization
SOUTHERN COLORADO NEPHROLOGY ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIETTE GIEBEL (OFFICE MANAGER)
(719) 561-5264
Entity
Organization
Contact information
Practice address
3426 LAKE AVE, 120, PUEBLO, CO 81004-3877
(719) 561-5264
(719) 561-5272
Mailing address
3426 LAKE AVE, 120, PUEBLO, CO 81004-3877
(719) 561-5264
(719) 561-5272
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04006250
—
CO
Enumeration date
06/29/2006
Last updated
11/02/2007
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