| Traumatic Brain Injury Of Southern Colorado, Pc | |
|
4117 N Elizabeth St Pueblo CO 81008-2009 | |
| (719) 520-1102 | |
| (719) 302-6686 |
| Full Name | Traumatic Brain Injury Of Southern Colorado, Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 4117 N Elizabeth St, Pueblo, Colorado |
| Authorized Official Name and Position | James H Evans (OWNER) |
| Authorized Official Contact | 7195201102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Traumatic Brain Injury Of Southern Colorado, Pc 402 W Bijou St Suite C Colorado Springs CO 80905-1309 Ph: (719) 520-1102 | Traumatic Brain Injury Of Southern Colorado, Pc 4117 N Elizabeth St Pueblo CO 81008-2009 Ph: (719) 520-1102 |
| NPI Number | 1386775781 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 10/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386775781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
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