Individual
DR. NICHOLAS MIMMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
871 COUNTY ROAD 501, BAYFIELD, CO 81122-9462
(970) 884-9133
(970) 884-0723
Mailing address
PO BOX 110, BAYFIELD, CO 81122-0110
(970) 884-9133
(970) 884-0723
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21790
CO
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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