Individual
GARY INGRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4800 BASELINE RD, BOULDER, CO 80303-2699
(303) 499-1919
Mailing address
4800 BASELINE RD, BOULDER, CO 80303-2699
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10356
CO
Other
Enumeration date
05/07/2011
Last updated
05/07/2011
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