Provider Demographics
NPI:1689917890
Name:MARSHALL, BROOKE LEIGH (PHARMD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:LEIGH
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 E COOPER AVE
Mailing Address - Street 2:SUITE A112
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-2011
Mailing Address - Country:US
Mailing Address - Phone:970-920-7230
Mailing Address - Fax:970-920-7240
Practice Address - Street 1:685 E COOPER AVE
Practice Address - Street 2:SUITE A112
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2011
Practice Address - Country:US
Practice Address - Phone:970-920-7230
Practice Address - Fax:970-920-7240
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19450183500000X
KY15933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist