MEDICARE: CURTIS B TUFFIN MALPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	289	CO

General Provider Information

NPI Number	:	1750307856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS B TUFFIN MALPC

Provider Business Mailing Address
First Line	:	503 N MAIN ST
Second Line	:	STE 640
City	:	PUEBLO
State	:	CO
Zip	:	81003-3174
Country	:	US
Telephone Number	:	719-542-6000
Fax Number	:	719-542-6037

Provider Business Practice Location Address
First Line	:	503 N MAIN ST
Second Line	:	STE 640
City	:	PUEBLO
State	:	CO
Zip	:	81003-3174
Country	:	US
Telephone Number	:	719-542-6000
Fax Number	:	719-542-6037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/08/2007

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