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Individual

MISS CRYSTAL MICHELLE LAZOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14241 E 4TH AVE # 5-120, AURORA, CO 80011-8733
(720) 508-3958
Mailing address
14241 E 4TH AVE # 5-120, AURORA, CO 80011-8733

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3034720414
CO
Enumeration date
04/28/2021
Last updated
04/28/2021
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