Individual
TARA MARIE SIDIQ CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
899 E INDUSTRIAL BLVD, PUEBLO WEST, CO 81007-1442
(719) 288-2135
Mailing address
921 W 16TH ST, PUEBLO, CO 81003-4011
(719) 696-4483
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
189458
CO
Other
Enumeration date
06/22/2024
Last updated
05/09/2025
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