Individual
ADINO DEMISSIE BOGALE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1218 S CARSON WAY # A, AURORA, CO 80012-4643
(720) 206-8178
(720) 428-8336
Mailing address
1218 S CARSON WAY, AURORA, CO 80012-4643
(720) 206-8178
(720) 428-8336
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
172A00000X
Driver
Primary
20151668889
CO
172A00000X
Driver
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6525203
THIS IS MY CREATING NUMBERS
CO
Enumeration date
05/12/2018
Last updated
05/12/2018
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