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1467173930
MARK MEDINA
PUEBLO, CO
NPI
1467173930
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: CO RN.1658172)
Enumeration Date
2022-09-05
Last Update Date
2022-09-05
Business Address
Mr. MARK MEDINA RN
1600 W 24TH ST
PUEBLO, CO 81003-1411
Phone number: 719-546-4000
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Mailing Address
Mr. MARK MEDINA RN
3115 FRANKLIN AVE
PUEBLO, CO 81008-1331
Phone number: 719-248-5043
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