Healthcare Provider Details

I. General information

NPI: 1871072835
Provider Name (Legal Business Name): FREDERICK K KUYLEN CNIM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 S ULSTER ST STE 1225
DENVER CO
80237-2696
US

IV. Provider business mailing address

4600 S ULSTER ST STE 1225
DENVER CO
80237-2696
US

V. Phone/Fax

Practice location:
  • Phone: 720-287-3093
  • Fax:
Mailing address:
  • Phone: 720-287-3093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number1158
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: