Individual
BREANNA SUSTAITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD.
Contact information
Practice address
65 TEJON ST, DENVER, CO 80223-1221
(970) 682-8696
Mailing address
65 TEJON ST, DENVER, CO 80223-1221
(970) 682-8696
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0021604
CO
Other
Enumeration date
02/17/2017
Last updated
03/12/2017
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