Individual
KAYLA LARAE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2781
(719) 584-4000
Mailing address
1204 MAUDSLAY AVE, PUEBLO, CO 81001-2513
(719) 369-9439
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24527
CO
Other
Enumeration date
01/08/2024
Last updated
01/09/2024
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