Individual
JAIME CARLOS HUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2003 AMACHE CIR, GRANADA, CO 81041-5004
(719) 688-1637
Mailing address
2003 AMACHE CIR, GRANADA, CO 81041-5004
(719) 688-1637
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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