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Individual

KENNETH BOOTH KURICA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5390 N ACADEMY BLVD, SUITE 300, COLORADO SPRINGS, CO 80918-4062
(719) 596-6110
(719) 596-6112
Mailing address
5390 N ACADEMY BLVD, SUITE 300, COLORADO SPRINGS, CO 80918-4062
(719) 596-6110
(719) 596-6112

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
23258
CO
247200000X
Other Technician
Primary
23258
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01232586
CO
Enumeration date
12/13/2005
Last updated
08/12/2009
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