Individual
MARY KAY WITTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1471 29TH LN, PUEBLO, CO 81006-9649
(719) 948-4609
Mailing address
1471 29TH LN, PUEBLO, CO 81006-9649
(719) 948-4609
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
7169
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13783840
—
CO
Enumeration date
05/24/2007
Last updated
07/09/2007
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