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Individual

JUSTIN TYLER BLANCHARD-QUINTANAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
660 BANNOCK ST, DENVER, CO 80204-4506
(130) 360-2795
Mailing address
235 W IRVINGTON PL, DENVER, CO 80223-1505
(172) 097-9745

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
30080943
CO
183700000X
Pharmacy Technician
Primary
PHAT.0000021
CO

Other

Enumeration date
06/23/2022
Last updated
06/29/2022
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