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1114960192
JED JITSUGO TATSUYAMA
PUEBLO, CO
NPI
1114960192
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CO 41404)
Enumeration Date
2006-06-14
Last Update Date
2008-04-30
Business Address
Dr. JED JITSUGO TATSUYAMA MD
1619 N GREENWOOD ST SUITE 200
PUEBLO, CO 81003-2644
Phone number: 719-543-1130
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Mailing Address
Dr. JED JITSUGO TATSUYAMA MD
1619 N GREENWOOD STREET SUITE 200
PUEBLO, CO 81003
Phone number: 719-543-1130
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