Individual
MR. JOHN RYAN VIALPANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
3470 BALTIMORE AVE, PUEBLO, CO 81008-1520
(719) 561-9850
(719) 545-4097
Mailing address
3470 BALTIMORE AVE, PUEBLO, CO 81008-1520
(719) 561-9850
(719) 545-4097
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
84 0810723
CO
Other
Enumeration date
11/02/2009
Last updated
11/02/2009
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