Individual
DARREL JAY VANDEEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 BELLFLOWER CT, PUEBLO, CO 81001-1101
(719) 641-3531
Mailing address
2 BELLFLOWER CT, PUEBLO, CO 81001-1101
(719) 641-3531
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
011420151
CO
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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