Healthcare Provider Details

I. General information

NPI: 1265758130
Provider Name (Legal Business Name): LAUREN MARIE KOLOWSKI D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2010
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 HOFFMAN DR SUITE H
LOVELAND CO
80538-4292
US

IV. Provider business mailing address

1762 HOFFMAN DR SUITE H
LOVELAND CO
80538-4292
US

V. Phone/Fax

Practice location:
  • Phone: 970-685-8060
  • Fax:
Mailing address:
  • Phone: 970-685-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number6497
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1611
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: