Individual
NATHAN ISAAC CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0004099
CO
Other
Enumeration date
10/07/2014
Last updated
03/02/2016
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