Individual
TYSON MERTLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2111 CHAMPA ST, DENVER, CO 80205-2529
(303) 312-9696
Mailing address
2111 CHAMPA ST, DENVER, CO 80205-2529
(303) 312-9696
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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