Provider Demographics
NPI:1245491612
Name:BURLASON, JESS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESS
Middle Name:
Last Name:BURLASON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6780 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1513
Mailing Address - Country:US
Mailing Address - Phone:303-770-2414
Mailing Address - Fax:303-770-9355
Practice Address - Street 1:6780 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-1513
Practice Address - Country:US
Practice Address - Phone:303-770-2414
Practice Address - Fax:303-770-9355
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist