Individual
JOSEPH A BULOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
300 COLORADO AVE, PUEBLO, CO 81004-2006
(719) 543-8711
(719) 543-0171
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
(719) 543-0171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1674
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51978873
—
CO
Enumeration date
07/03/2006
Last updated
06/23/2016
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