Individual
ROMAN KOMLEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 RIVER POINT PKWY, SHERIDAN, CO 80110-3316
(303) 200-1839
Mailing address
PO BOX 921, FORT LUPTON, CO 80621-0921
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0024512
CO
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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