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1366503138
LARRY E. BLOSSOM
PUEBLO, CO
NPI
1366503138
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: VA 0701002333)
Enumeration Date
2006-12-13
Last Update Date
2022-04-19
Business Address
Mr. LARRY E. BLOSSOM M.A.
611 S UNION AVE APT A
PUEBLO, CO 81004-2250
Phone number: 719-696-4252
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Mailing Address
Mr. LARRY E. BLOSSOM M.A.
3225 INDEPENDENCE RD
CANON CITY, CO 81212-9380
Phone number: 719-275-2351
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