Individual
KEIRU HALEWI MUKTAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 S TEJON ST STE 1100, COLORADO SPRINGS, CO 80903-2253
(720) 207-8796
Mailing address
PO BOX 200912, DENVER, CO 80220-0912
(720) 207-8796
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
20221788177
CO
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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