Individual
MRS. DANA J WEAVER-OSTERHOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4740 KATAHDIN LN, PUEBLO, CO 81004
(719) 676-3728
Mailing address
4740 KATAHDIN LN, PUEBLO, CO 81004
(719) 676-3728
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40134
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48477877
—
CO
Enumeration date
06/20/2005
Last updated
09/23/2015
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