Organization
LASER REMODEL AND CONSTRUCTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN GREGORY (LICENSED CONTRACTOR/GENERAL MANAGER)
(719) 565-8480
Entity
Organization
Contact information
Practice address
2406 W 11TH ST, PUEBLO, CO 81003-1102
(719) 565-8480
Mailing address
2406 W 11TH ST, PUEBLO, CO 81003-1102
(719) 565-8480
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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