| Southern Colorado Psychiatric P.c. | |
|
1925 E Orman Ave Ste G12 Pueblo CO 81004-3563 | |
| (719) 564-1800 | |
| (719) 564-1865 |
| Full Name | Southern Colorado Psychiatric P.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1925 E Orman Ave Ste G12, Pueblo, Colorado |
| Authorized Official Name and Position | Mary Wright (AUTHORIZED AGENT) |
| Authorized Official Contact | 7195641800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Colorado Psychiatric P.c. 1925 E Orman Ave Ste G12 Pueblo CO 81004-3563 Ph: (719) 564-1800 | Southern Colorado Psychiatric P.c. 1925 E Orman Ave Ste G12 Pueblo CO 81004-3563 Ph: (719) 564-1800 |
| NPI Number | 1912028564 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 07/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912028564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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