Organization
SOUTHERN COLORADO ENT & ALLERGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C MCLEAN MD, PHD (OWNER, PROVIDER)
(719) 647-9286
Entity
Organization
Contact information
Practice address
3676 PARKER BLVD STE 320, PUEBLO, CO 81008-2213
(719) 296-6989
(719) 296-6990
Mailing address
3676 PARKER BLVD STE 320, PUEBLO, CO 81008-2213
(719) 296-6989
(719) 296-6990
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
41367
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35883545
—
CO
Enumeration date
04/03/2007
Last updated
06/13/2011
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