NPI | 1588415517 |
---|---|
Doing Business As | MARC PUEBLO MH |
Entity Type | Organization |
Authorized Contact | JENNIFER RUDNIK Credentialing Manager 719-423-1341 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X |
Enumeration Date | 2024-03-28 |
Last Update Date | 2024-03-28 |