Individual
PHANUEL ROWLANDS OMULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2130 STOUT ST, DENVER, CO 80205-2827
(303) 312-9978
Mailing address
2111 CHAMPA ST, DENVER, CO 80205-2529
(303) 293-2220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
08/24/2021
Last updated
02/07/2023
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