Individual
JOAN M BODAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8383 W ALAMEDA AVE, LAKEWOOD, CO 80226-3007
(303) 239-7358
Mailing address
7900 W LAYTON AVE, #847, DENVER, CO 80123-1301
(303) 948-3702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
66374
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005482
KAISER-COMMERCIAL NUMBER
—
Enumeration date
02/16/2007
Last updated
07/08/2007
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