Individual
HABTOM HADUSH GEBREWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12526 E CORNELL AVE UNIT 102, AURORA, CO 80014
(702) 727-9372
Mailing address
12526 E CORNELL AVE UNIT 102, AURORA, CO 80014
(702) 727-9372
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
20151667853
CO
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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