Individual
MR. VLASTISLAV MAREK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
6915 TUTT BOULEVARD, SUITE #110B, COLORADO SPRINGS, CO 80923
(719) 445-1292
(719) 591-6486
Mailing address
2109 PEACEMAKER TER W, COLORADO SPRINGS, CO 80920-3815
(719) 351-5288
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1631454
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0997172-NP
CO
363LF0000X
Family Nurse Practitioner
RXN.0106234-NP
CO
Other
Enumeration date
09/08/2021
Last updated
03/07/2022
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