Individual
SUZANNE M PETLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(720) 536-7598
Mailing address
11517 DEPEW WAY, WESTMINSTER, CO 80020-6857
(303) 438-8421
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47402
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006519
KAISER-COMMERCIAL NUMBER
—
Enumeration date
02/16/2007
Last updated
07/08/2007
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