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General NPI Number Information
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NPI Number | 1750789970
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Entity Type | Individual
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Provider Name | DAVID CHARTRAND BC-HIS
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Gender | Male
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 509 COLORADO AVE SUITE A
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City | PUEBLO
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State | CO
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Zip | 81004-2008
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Country | US
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Telephone | 719-582-1614
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Fax | 719-924-9359
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Provider Business Mailing Address
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Address Line | 509 COLORADO AVE SUITE A
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City | PUEBLO
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State | CO
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Zip | 81004-2008
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Country | US
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Telephone | 719-582-1614
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Fax | 719-924-9359
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HAD. 0000159
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License Number State | CO
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