Individual
EBONY VILLARREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1214 S SHERIDAN BLVD DEPT, DENVER, CO 80232-8022
(303) 233-4671
(303) 935-7597
Mailing address
1214 S SHERIDAN BLVD DEPT, DENVER, CO 80232-8022
(303) 233-4671
(303) 935-7597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4307
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38135043
—
CO
Enumeration date
06/12/2015
Last updated
11/06/2018
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