Individual
KIMBERLY K TIESZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1122 E FIRST ST, TRINIDAD, CO 81082-3102
(719) 859-1184
Mailing address
1122 E FIRST ST, TRINIDAD, CO 81082-3102
(719) 859-1184
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHR.0008064
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C738KA
MINNESOTA BCBS
MN
01
—
82571
GEISINGER HEALTH PLAN
PA
01
—
TI374867
HIGHMARK BCBS
PA
Enumeration date
12/27/2005
Last updated
06/06/2024
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