Individual
CHERYL LYNN LIEDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2450 S PEORIA ST STE 245, AURORA, CO 80014
(303) 752-7732
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4451
(970) 490-4199
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0004488
CO
363A00000X
Physician Assistant
PA9101925
FL
363AS0400X
Surgical Physician Assistant
PA9101925
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000169533
—
CO
Enumeration date
08/07/2006
Last updated
02/05/2019
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