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NPI Code Detail

MEDICARE: BRIELLE DUDEK D.C.

MEDICARE:   BRIELLE  DUDEK  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor6604CO

General Provider Information

NPI Number : 1629341623
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIELLE DUDEK D.C.
Provider Business Mailing Address
First Line : 2532 SHERIDAN BLVD
Second Line :
City : DENVER
State : CO
Zip : 80214-3017
Country : US
Telephone Number : 303-922-2977
Fax Number :
Provider Business Practice Location Address
First Line : 2532 SHERIDAN BLVD
Second Line :
City : DENVER
State : CO
Zip : 80214-3017
Country : US
Telephone Number : 303-922-2977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2012
Last Update Date : 02/22/2012

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Directions to “ BRIELLE DUDEK D.C.” Practice Location

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