Organization
PUEBLO CHEMICAL AGENT-DESTRUCTION PILOT PLANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL GLENN MERCHANT JR. MD (MEDICAL DIRECTOR)
(719) 549-5483
Entity
Organization
Contact information
Practice address
45825 E STATE HIGHWAY 96, PUEBLO, CO 81006-9330
(719) 549-5483
Mailing address
45825 E STATE HIGHWAY 96, PUEBLO, CO 81006-9330
(719) 549-5483
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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