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General NPI Number Information
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NPI Number | 1861617607
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Entity Type | Organization
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Legal Business Name | LUITHUK ZIMIK, MD, PC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 70 S 20TH AVE
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City | BRIGHTON
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State | CO
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Zip | 80601-3703
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Country | US
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Telephone | 303-659-1042
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Fax | 303-659-4571
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Provider Business Mailing Address
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Address Line | 70 S 20TH AVE
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City | BRIGHTON
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State | CO
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Zip | 80601-3703
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Country | US
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Telephone | 303-659-1042
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Fax | 303-659-4571
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Authorized Official
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Title or Position | MANAGER
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Name | MR. MASOTHING ZIMIK
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Credential |
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Telephone | 303-659-1042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 20021258301
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License Number State | CO
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