Individual
TAPAN BANTAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4745 ARAPAHOE AVE STE 140, BOULDER, CO 80303-1082
(720) 214-0963
Mailing address
12668 JASMINE ST, THORNTON, CO 80602-4666
(303) 717-3364
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0024947
CO
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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