Individual
JESSICA KAZAKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1632 YORK ST, 4, DENVER, CO 80206-1444
(631) 921-5349
Mailing address
1632 YORK ST, 4, DENVER, CO 80206-1444
(631) 921-5349
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12296
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12296
MEDICARE
CO
Enumeration date
08/09/2013
Last updated
08/09/2013
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