Individual
SAMUEL ADAM GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 AVIS AVE, PUEBLO, CO 81005-3102
(719) 256-0127
(719) 258-1327
Mailing address
4 AVIS AVE, PUEBLO, CO 81005-3102
(719) 256-0127
(719) 258-1327
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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