Individual
MR. SALVADOR R HERNANDEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5802 PIONEER MESA DR, COLORADO SPRINGS, CO 80923-8804
(956) 310-2967
Mailing address
5802 PIONEER MESA DR, COLORADO SPRINGS, CO 80923-8804
(956) 310-2967
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
20221898066
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92-0363466
MOBILE LAB SERVICE
CO
Enumeration date
10/28/2022
Last updated
10/28/2022
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