Provider Demographics
NPI:1568730257
Name:BELL, LETICIA L (RPH)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:L
Last Name:BELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 W HIGHWAY 105
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132
Mailing Address - Country:US
Mailing Address - Phone:719-219-1288
Mailing Address - Fax:719-219-1294
Practice Address - Street 1:265 W. HIGHWAY 105
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132
Practice Address - Country:US
Practice Address - Phone:719-219-1288
Practice Address - Fax:719-219-1294
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist