Individual
MRS. RENEE JOAN SPRAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3717 AZALEA ST, PUEBLO, CO 81005-3004
(719) 994-1674
Mailing address
3717 AZALEA ST, PUEBLO, CO 81005-3004
(719) 994-1674
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
34696
CO
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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