Individual
TARA MARIE CRISTALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
777 BANNOCK ST # MC0108, DENVER, CO 80204-4507
(303) 602-5193
Mailing address
777 BANNOCK ST # MC0108, DENVER, CO 80204-4597
(303) 602-5193
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TL.0009615
CO
Other
Enumeration date
04/02/2022
Last updated
04/02/2023
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