Individual
JOSAFATH BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4117 N ELIZABETH ST, PUEBLO, CO 81008-2009
(719) 545-0788
Mailing address
3229 WESTVIEW DR, PUEBLO, CO 81003-3858
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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