Healthcare Provider Details

I. General information

NPI: 1013167931
Provider Name (Legal Business Name): MARK C FILAK RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2008
Last Update Date: 09/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 W 4TH AVE UNIT 24
DENVER CO
80223-1036
US

IV. Provider business mailing address

795 S ALTON WAY 1-C
DENVER CO
80247-1845
US

V. Phone/Fax

Practice location:
  • Phone: 303-936-0330
  • Fax:
Mailing address:
  • Phone: 303-365-8806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number1274
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: