Provider Demographics
NPI:1114627635
Name:MY KIT FREE LLC
Entity Type:Organization
Organization Name:MY KIT FREE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-691-0366
Mailing Address - Street 1:6833 S DAYTON ST # 255
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3624
Mailing Address - Country:US
Mailing Address - Phone:606-691-0366
Mailing Address - Fax:606-328-6128
Practice Address - Street 1:5400 FORT ST STE 210
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-4630
Practice Address - Country:US
Practice Address - Phone:734-676-5353
Practice Address - Fax:855-552-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare