| Tabeguache Family & Sports Medicine | |
|
3150 N 12th St Grand Junction CO 81506-2863 | |
| (970) 256-5201 | |
| (970) 256-5202 |
| Full Name | Tabeguache Family & Sports Medicine |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 3150 N 12th St, Grand Junction, Colorado |
| Authorized Official Name and Position | Beverly J Clark (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9702542642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tabeguache Family & Sports Medicine Po Box 10700 Grand Junction CO 81502-5517 Ph: (970) 254-2642 | Tabeguache Family & Sports Medicine 3150 N 12th St Grand Junction CO 81506-2863 Ph: (970) 256-5201 |
| NPI Number | 1417455403 |
|---|---|
| Provider Enumeration Date | 01/25/2018 |
| Last Update Date | 01/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417455403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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