Individual
MR. JOHN D. KUTZKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
SELAH MOUNTAIN PHARMACY, 426 PAGOSA STREET, PAGOSA SPRINGS, CO 81147
(970) 264-0126
(970) 507-6111
Mailing address
PO BOX 623, PAGOSA SPRINGS, CO 81147-0623
(941) 321-8067
(970) 507-6111
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA.0019440
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62239
TEXAS BOARD OF PHARMACY
TX
01
—
PHA.0019440
COLORADO BOARD OF PHARMACY
CO
01
—
PS21744
FLORIDA BOARD OF PHARMACY
FL
01
—
RP00007870
NEW MEXICO BOARD OF PHARMACY
NM
Enumeration date
07/13/2017
Last updated
06/09/2020
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