Most Relevant Information
Provider Data
| NPI Number: | 1003414988 |
| Provider Name: | ADDISU ALEMU BIREGA |
| Entity Type: | Individual |
| Taxonomy Code: | 172A00000X |
| Specialty: | Driver |
| License Number: | 170848260 |
Most Important Dates
| Enumeration Date: | 10/13/2020 |
| Last Updated: | 10/13/2020 |
Provider Practice Location
600 S DAYTON ST APT 3-203
DENVER
CO
802471330
Practice Location Phone/Fax
| Phone: | 7202407420 |
| Fax: |
Provider Mailing Location
600 S DAYTON ST APT 3-203
DENVER
CO
802471330
Provider Mailing Phone/Fax
| Phone: | 7202407420 |
| Fax: |