OrganizationActive
Ent Clinic of Pueblo Prof LLC
NPI 1376595504 · Otolaryngology Physician · Pueblo, CO
Provider details
- NPI number
- 1376595504
- Entity type
- Organization
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Charlene Hickson, Owner/Partner
Practice location
1304 N Grand Ave
Pueblo, CO 81003-2759
Phone: (719) 544-3752
Fax: (719) 542-1794
Mailing address
1304 N Grand Ave
Pueblo, CO 81003-2759
Registry dates
- Enumerated
- 2006-05-16
- Last updated
- 2008-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.