Individual
KIMLIEN THAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 COALTON RD, SUPERIOR, CO 80027-4630
(303) 465-3024
Mailing address
9916 W 99TH PL, WESTMINSTER, CO 80021-6832
(303) 882-2636
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1942216312
CO
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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