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1922001700
STEPHEN D BAST
PUEBLO, CO
NPI
1922001700
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CO PA.0004346)
Enumeration Date
2005-05-24
Last Update Date
2016-01-18
Business Address
-- STEPHEN D BAST PA-C
3676 PARKER BLVD
PUEBLO, CO 81008-2212
Phone number: 719-553-2208
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Mailing Address
-- STEPHEN D BAST PA-C
PO BOX 9000
PUEBLO, CO 81008-9000
Phone number: 719-553-2208
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