Individual
JESUS CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
174 CORNELL CIR, PUEBLO, CO 81005-1928
(719) 994-8890
Mailing address
174 CORNELL CIR, PUEBLO, CO 81005-1928
(719) 994-8890
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
05/07/2022
Last updated
05/27/2022
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