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General NPI Number Information
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NPI Number | 1518575398
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Entity Type | Individual
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Provider Name | ERIK WILLIS
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Gender | Male
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 18550 GREEN VALLEY RANCH BLVD
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City | DENVER
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State | CO
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Zip | 80249-6831
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Country | US
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Telephone | 720-214-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 E YALE AVE APT J208
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City | DENVER
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State | CO
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Zip | 80231-6063
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Country | US
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Telephone | 406-403-2107
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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 | 0023170
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License Number State | CO
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