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General NPI Number Information
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NPI Number | 1346037330
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Entity Type | Individual
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Provider Name | SETH NIXON
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Gender | Male
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 700 W ABRIENDO AVE
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City | PUEBLO
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State | CO
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Zip | 81004-1546
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Country | US
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Telephone | 719-562-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 CONSTITUTION RD
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City | PUEBLO
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State | CO
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Zip | 81001-2104
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Country | US
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Telephone | 719-469-5767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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