Individual
JOSE RAFAEL URIARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
311 E SPRUCE ST, GARDEN CITY, KS 67846-5614
(620) 275-3006
Mailing address
718 BERKELEY AVE, ALAMOSA, CO 81101-2002
(719) 298-2252
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
24-01217
KS
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
AT.0001864
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24-01217
ATHLETIC TRAINING LICENSE
KS
01
—
AT.0001864
ATHLETIC TRAINING LICENSE
CO
Enumeration date
09/08/2017
Last updated
09/18/2022
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