Individual
WENDY A BULOW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
110 E ROUTT, PUEBLO, CO 81004
(719) 543-8711
(719) 543-5340
Mailing address
310 COLORADO AVE, PUEBLO, CO 81004
(719) 543-8718
(719) 543-5340
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1675
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85478075
—
CO
Enumeration date
06/23/2006
Last updated
07/08/2007
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