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General NPI Number Information
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NPI Number | 1417391822
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Entity Type | Individual
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Provider Name | MARTA L NEILL
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Gender | Female
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 1220 S LIPAN ST
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City | DENVER
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State | CO
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Zip | 80223-3069
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Country | US
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Telephone | 303-698-8971
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Fax | 303-698-8975
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Provider Business Mailing Address
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Address Line | 374 SAXONY RD
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City | JOHNSTOWN
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State | CO
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Zip | 80534-9298
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Country | US
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Telephone | 970-218-9042
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Fax | 303-698-8975
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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 | 13149
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17184
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License Number State | IA
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