Individual
MULUNEH MEKUANENT TIZAZU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1420 MOLINE ST APT 306, AURORA, CO 80010-3628
(720) 231-2805
Mailing address
6165 LEHMAN DR STE 203-7, COLORADO SPRINGS, CO 80918-3441
(720) 231-2805
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
071210632
CO
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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