| Teresa Koppin | |
|
421 N Main St Ste 301 Pueblo CO 81003-3187 | |
| (719) 251-5222 | |
| (719) 562-0129 |
| Full Name | Teresa Koppin |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 421 N Main St Ste 301, Pueblo, Colorado |
| Authorized Official Name and Position | Teresa A Koppin (OWNER) |
| Authorized Official Contact | 7192515222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Teresa Koppin 421 N Main St Ste 301 Pueblo CO 81003-3187 Ph: (719) 251-5222 | Teresa Koppin 421 N Main St Ste 301 Pueblo CO 81003-3187 Ph: (719) 251-5222 |
| NPI Number | 1801297478 |
|---|---|
| Provider Enumeration Date | 09/15/2014 |
| Last Update Date | 09/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801297478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0011162 (Colorado) | Primary |
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