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General NPI Number Information
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NPI Number | 1023387206
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Entity Type | Individual
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Provider Name | DR. ADETOLA A OBIWOLE
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Gender | Female
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Dates
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Enumeration Date | 12/18/2011
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 4602 N ELIZABETH STREET STE. 190
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City | PUEBLO
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State | CO
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Zip | 81008-2093
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Country | US
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Telephone | 800-517-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 5166 DILLON ST
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City | DENVER
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State | CO
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Zip | 80239-4140
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Country | US
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Telephone | 303-257-2150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18884
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License Number State | CO
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