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Organization

PRAIRIE MEDICAL CLINIC PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN MARTINEZ MD (PHYSICIAN)
(719) 561-1291
Entity
Organization

Contact information

Practice address
1726 S PRAIRIE AVE, PUEBLO, CO 81005-2253
(719) 561-8660
(719) 561-8660
Mailing address
1726 S PRAIRIE AVE, PUEBLO, CO 81005-2253
(719) 561-8660
(719) 561-8660

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CO

Other

Enumeration date
04/24/2007
Last updated
08/22/2020
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