Healthcare Provider Details

I. General information

NPI: 1538548920
Provider Name (Legal Business Name): LYNNE TOEDTLI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 05/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8941 HARLAN ST
WESTMINSTER CO
80031-2931
US

IV. Provider business mailing address

1138 CONEFLOWER WAY
BRIGHTON CO
80601-6785
US

V. Phone/Fax

Practice location:
  • Phone: 303-993-8604
  • Fax: 844-311-3590
Mailing address:
  • Phone: 303-909-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15262
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: