Individual
STEPHANIE DIANE LOUDERBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2853 NORTH AVE, GRAND JUNCTION, CO 81501-5040
(970) 256-9424
Mailing address
3737 F 1/4 RD, PALISADE, CO 81526-9331
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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