Individual
KIRSTEN D BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1517 E 6TH ST, PUEBLO, CO 81001-3231
(719) 565-7104
Mailing address
PO BOX 245, FORT THOMPSON, SD 57339-0245
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
CO
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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