Individual
MR. MICHAEL EDWARD KODITEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5900 KEYES ST STE 101, FREDERICK, CO 80504-5956
(303) 833-1056
(303) 833-1057
Mailing address
5900 KEYES ST STE 101, FREDERICK, CO 80504-5956
(303) 833-1056
(303) 833-1057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2850
CO
Other
Enumeration date
05/25/2011
Last updated
03/13/2020
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