Provider Demographics
NPI:1053639559
Name:CZEZOWSKI, CAITLIN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:MARIE
Last Name:CZEZOWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1699 S COLORADO BLVD
Mailing Address - Street 2:UNIT M
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4036
Mailing Address - Country:US
Mailing Address - Phone:303-953-1471
Mailing Address - Fax:303-945-4172
Practice Address - Street 1:1699 S COLORADO BLVD
Practice Address - Street 2:UNIT M
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4036
Practice Address - Country:US
Practice Address - Phone:303-953-1471
Practice Address - Fax:303-945-4172
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6451111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor