Provider Demographics
NPI:1568741312
Name:CHICK, ANTONY (CPHT)
Entity Type:Individual
Prefix:MR
First Name:ANTONY
Middle Name:
Last Name:CHICK
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 E YALE AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7156
Mailing Address - Country:US
Mailing Address - Phone:303-691-8874
Mailing Address - Fax:303-691-0557
Practice Address - Street 1:6460 E YALE AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7156
Practice Address - Country:US
Practice Address - Phone:303-691-8874
Practice Address - Fax:303-691-0557
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO140108590162257183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician