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General NPI Number Information
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NPI Number | 1699780361
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Entity Type | Organization
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Legal Business Name | STANLEY C. RHEAUME, DPM, PC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 1513 MOORE AVE
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City | PUEBLO
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State | CO
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Zip | 81005-2346
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Country | US
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Telephone | 719-564-2391
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Fax | 719-564-2393
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Provider Business Mailing Address
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Address Line | 1513 MOORE AVE
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City | PUEBLO
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State | CO
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Zip | 81005-2346
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Country | US
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Telephone | 719-564-2391
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Fax | 719-564-2393
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GORDON PAUL RHEAUME
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Credential | DPM
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Telephone | 719-564-2391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 417
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License Number State | CO
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