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General NPI Number Information
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NPI Number | 1891090288
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Entity Type | Organization
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Legal Business Name | KSIAZEK MEDICAL SERVICES P.C.
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Dates
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Enumeration Date | 01/17/2011
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 65 S WADSWORTH BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80226-1513
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Country | US
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Telephone | 303-934-3600
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Fax | 303-934-1559
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Provider Business Mailing Address
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Address Line | 65 S WADSWORTH BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80226-1513
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Country | US
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Telephone | 303-934-3600
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Fax | 303-934-1559
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAREN KSIAZEK
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Credential | MD
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Telephone | 303-934-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 30621
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License Number State | CO
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