Organization
SOUTHERN COLORADO CLINIC PC
Active
Parent organization
SOUTHERN COLORADO CLINIC PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN COLORADO CLINIC PC
Authorized official
EVANGELINE (EVIE) HARRIS (CREDENTIALING SPECIALIST)
(719) 553-1804
Entity
Organization
Contact information
Practice address
2403 SANTA FE DR STE 7, PUEBLO, CO 81006-1497
(719) 553-2200
Mailing address
PO BOX 9000, PUEBLO, CO 81008-9000
(719) 553-2200
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
03/26/2024
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