Organization
PUEBLO NEUROSCIENCE LLC
Active
Other names
Pueblo Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMANT RAWAT M.D. (OWNER)
(719) 564-0883
Entity
Organization
Contact information
Practice address
1925 E ORMAN AVE, SUITE G32, PUEBLO, CO 81004-3537
(719) 564-0883
(719) 564-0861
Mailing address
1925 E ORMAN AVE, SUITE G32, PUEBLO, CO 81004-3537
(719) 564-0883
(719) 564-0861
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14355779
—
CO
Enumeration date
06/02/2006
Last updated
04/07/2008
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