Individual
WILLIAM J PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
264 CRADLE LAKE DR, DIVIDE, CO 80814-9780
(719) 687-3412
Mailing address
264 CRADLE LAKE DR, DIVIDE, CO 80814-9780
(719) 687-3412
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33188564
—
CO
Enumeration date
04/24/2009
Last updated
04/24/2009
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