Individual
LINDA G GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D., RPH
Contact information
Practice address
3497 HWY 72 #85, PINECLIFFE, CO 80471-8047
(303) 619-1743
Mailing address
PO BOX 483, PINECLIFFE, CO 80471-0483
(303) 619-1743
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA0016239
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHA0016239
PHARMACIST LICENSE
CO
Enumeration date
09/07/2018
Last updated
09/07/2018
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