Individual
SUSAN S PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15131 E CRESTLINE AVE, CENTENNIAL, CO 80015-2517
(720) 289-2021
Mailing address
15131 E CRESTLINE AVE, CENTENNIAL, CO 80015-2517
(720) 289-2021
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14864
CO
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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