Individual
TAMALA LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34061 FOREST PARK DR, ELIZABETH, CO 80107-7842
(303) 646-4071
Mailing address
PO BOX 1272, ELIZABETH, CO 80107-1272
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
712126
CO
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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