Individual
ANDREW JERRY GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5855
Mailing address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5855
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
TL.0011406
CO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
NA
CO
Other
Enumeration date
04/01/2026
Last updated
05/04/2026
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