Organization
KENNETH D DANYLCHUK, MD, PC
Active
Other names
Maple Leaf Orthopedics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANA D STOLLSTEIMER (OFFICE MANAGER)
(719) 296-9000
Entity
Organization
Contact information
Practice address
3530 SPAULDING AVE, PUEBLO, CO 81008-2209
(719) 296-9000
(719) 296-9001
Mailing address
3530 SPAULDING AVE, PUEBLO, CO 81008-2209
(719) 296-9000
(719) 296-9001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29760
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01297605
—
CO
Enumeration date
07/02/2007
Last updated
11/11/2010
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