Individual
MR. TERRY R ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 543-7877
(719) 543-7882
Mailing address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 543-7877
(719) 543-7882
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
92845
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
92846
CO
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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