Individual
TROY E. SAMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.AC.O.M., L.AC.
Contact information
Practice address
115 W 11TH ST, PUEBLO, CO 81003-2801
(719) 544-3326
Mailing address
888 S AVENIDA DEL ORO W, PUEBLO WEST, CO 81007-6191
(719) 250-4090
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
567
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611913700
WORKERS COMPENSATION ID
CO
01
—
651493
ANTHEM BC BS
CO
Enumeration date
04/18/2007
Last updated
02/16/2010
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