CORWIN CLINIC SURGICAL PROFESSIONAL CORP NPI 1356492219

NPI Information

CORWIN CLINIC SURGICAL PROFESSIONAL CORP is a specialist in Pueblo, CO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CORWIN CLINIC SURGICAL PROFESSIONAL CORP NPI is 1356492219. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Corwin Clinic Surgical, Pc.

The provider's business location address is:

1925 E ORMAN AVE STE A109
PUEBLO, CO
ZIP 81004-555
Phone: (719) 564-0210
Fax: (719) 564-9483

The provider's authorized official is Gary E. Lane .
The authorized official title is President and has the following contact phone number (719) 564-0210.

The CLIA number assigned to this NPI record is 06D2096970 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 3/23/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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