Individual
ROGER HIMELRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1026 W ABRIENDO AVE, PUEBLO, CO 81004-1128
(719) 545-2743
(719) 545-4100
Mailing address
1302 CHINOOK LN, PUEBLO, CO 81001-1851
(719) 545-2746
(719) 545-4100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
ACB.0007288
CO
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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