Individual
MR. DYLAN B DEVRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
(719) 543-0171
Mailing address
1302 E 5TH ST, PUEBLO, CO 81001-3754
(719) 543-8711
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004735
GA
Other
Enumeration date
01/25/2008
Last updated
06/13/2016
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