Organization
JANDYCO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE M POLLOCK M.D. (OWNER/ PHYSICIAN)
(719) 214-2005
Entity
Organization
Contact information
Practice address
509 COLORADO AVE STE C, PUEBLO, CO 81004-2008
(719) 696-9828
(719) 696-9862
Mailing address
509 COLORADO AVE STE C, PUEBLO, CO 81004-2008
(719) 214-2005
(719) 696-9862
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
44011
CO
261QP2300X
Primary Care Clinic/Center
44011
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29732581
—
CO
Enumeration date
12/28/2012
Last updated
07/21/2022
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