Debolt, Mark

Debolt, Mark is an individual health care provider with primary practice located at 1414 Main St , Canon City CO 81212-3906. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Debolt, Mark can be contacted via phone (719) 275-7511.

Contact Information

Primary practice address
1414 Main St Canon City CO 81212-3906
Phone: (719) 275-7511
Fax: (719) 275-7161
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 16607 Colorado

Profile Details

NPI number 1659671154
LBN Legal business name Debolt, Mark
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2010
Last updated Oct 30th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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