Healthcare Provider Details

I. General information

NPI: 1053639559
Provider Name (Legal Business Name): CAITLIN MARIE CZEZOWSKI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 05/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1699 S COLORADO BLVD UNIT M
DENVER CO
80222-4036
US

IV. Provider business mailing address

1699 S COLORADO BLVD UNIT M
DENVER CO
80222-4036
US

V. Phone/Fax

Practice location:
  • Phone: 303-953-1471
  • Fax: 303-945-4172
Mailing address:
  • Phone: 303-953-1471
  • Fax: 303-945-4172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6451
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: