Organization
PHYSICAL, REHABILITATIVE AND OCCUPATIONAL MEDICINE CENTER LLC
Active
Other names
PRO Medicine LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT KEITH CAUGHFIELD MD (OWNER)
(719) 545-7802
Entity
Organization
Contact information
Practice address
511 W 29TH ST, SUITE B, PUEBLO, CO 81008-1128
(719) 545-7802
(719) 545-7804
Mailing address
511 W 29TH ST, SUITE B, PUEBLO, CO 81008-1128
(719) 545-7802
(719) 545-7804
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
30495
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01304955
—
CO
Enumeration date
03/16/2007
Last updated
08/22/2020
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