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ALEXANDRA THERIAULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1420 W CANAL CT, #50, LITTLETON, CO 80120-5655
(303) 795-2030
(303) 795-2153
Mailing address
1420 W CANAL CT, #50, LITTLETON, CO 80120-5655
(303) 795-2030
(303) 795-2153

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
38122
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
59251573
CO
Enumeration date
08/18/2006
Last updated
02/01/2010
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