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Individual

DR. JON EDWARD EGGERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
EDD

Contact information

Practice address
327 COLORADO AVE, PUEBLO, CO 81004-2005
(719) 948-7120
Mailing address
327 COLORADO AVE, PUEBLO, CO 81004-2005
(719) 948-7120

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY.0002439
CO
103TC1900X
Counseling Psychologist
2439
CO

Other

Enumeration date
02/10/2021
Last updated
03/09/2021
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