Individual
MARIAH MCGINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1232 VAN BUREN ST., PUEBLO, CO 81004
(719) 545-2069
Mailing address
1232 VAN BUREN ST, PUEBLO, CO 81004-2834
(719) 545-2069
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0178977
CO
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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