Individual
THERESE JEAN COLALANCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 595-7900
Mailing address
1 MALIBU CT, PUEBLO, CO 81005-2991
(719) 320-2147
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11987
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11987
PHARMACY LICENSE
CO
Enumeration date
10/15/2018
Last updated
10/15/2018
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