Individual
MARIO JAMIE CORNEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 W ABRIENDO AVE, PUEBLO, CO 81004-1003
(719) 543-1173
(719) 543-6325
Mailing address
1201 W ABRIENDO AVE, PUEBLO, CO 81004-1003
(719) 543-1173
(719) 543-6325
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0012995
CO
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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