Provider Demographics
NPI:1407621691
Name:SPROWL, CYTHIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CYTHIA
Middle Name:
Last Name:SPROWL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:OWALLAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1375 E 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1114
Mailing Address - Country:US
Mailing Address - Phone:303-812-2300
Mailing Address - Fax:
Practice Address - Street 1:1359 HICKORY DRIVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-7926
Practice Address - Country:US
Practice Address - Phone:214-235-5692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist