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Sc Telehealth Clinic LLC

Clinic/Center, Health Services in Pueblo, CO. Organization (NPI-2).

NPI number1962032003
StatusActive
Last updated in NPPESJan 16, 2020

Details

NPI
1962032003
Entity type
Organization (NPI-2)
Legal business name
Sc Telehealth Clinic LLC
Organization subpart
No
Enumeration date
Jan 16, 2020
Certification date
Jan 16, 2020
Last updated
Jan 16, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QH0100X Clinic/Center, Health Services––Yes

Practice location

1013 Candytuft Blvd
Pueblo, CO 81001-1026

Phone 719-582-7287

Mailing address

1013 Candytuft Blvd
Pueblo, CO 81001-1026

Phone 719-582-7287

Authorized official

Renee D Fasano
Owner Manager
7195827287

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