| NPI | 1972556744 |
|---|---|
| Doing Business As | SAN LUIS VALLEY HEALTH STUART AVENUE CLINIC |
| Entity Type | Organization |
| Authorized Contact | KONNIE MARTIN C.E.O. 719-587-1206 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 011001) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 011001) |
| 207Q00000X Family Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-11-24 |