Individual
JACOBY EWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 VILLAGE PARK DR APT C207, LITTLETON, CO 80122-2748
(801) 649-8582
Mailing address
240 VILLAGE PARK DR APT C207, LITTLETON, CO 80122-2748
(801) 649-8582
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23408
CO
Other
Enumeration date
01/23/2021
Last updated
01/23/2021
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