Individual
MICHAEL D. DUFAUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4736
Mailing address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4736
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
38299
—
Other
Enumeration date
07/07/2006
Last updated
07/08/2007
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