Individual
KARL NIESCHBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
100 KENDALL DR, LAMAR, CO 81052
(719) 336-7501
(719) 336-7453
Mailing address
711 BARNES AVE, LA JUNTA, CO 81050
(719) 384-5446
(719) 384-5672
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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