Organization
KLARISANA PHYSICIAN SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALYSSA SOTO (ADMINISTRATIVE DIRECTOR)
(210) 556-1430
Entity
Organization
Contact information
Practice address
916 S MAIN ST UNIT 208, LONGMONT, CO 80501-6617
(210) 556-1430
(888) 504-2390
Mailing address
8600 WURZBACH RD STE 1110, SAN ANTONIO, TX 78240-4334
(210) 556-1430
(888) 504-2390
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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