Individual
SHEALYNN PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 W 22ND ST, DURANGO, CO 81301-4618
(970) 259-0968
Mailing address
954 HILLTOP DR., BAYFIELD, CO 81122
(970) 281-9831
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT.0016046
CO
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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