Provider Demographics
NPI:1184840787
Name:BILKOVA, MARKETA (LAC)
Entity Type:Individual
Prefix:MS
First Name:MARKETA
Middle Name:
Last Name:BILKOVA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 BRANCIFORTE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-9741
Mailing Address - Country:US
Mailing Address - Phone:831-427-2515
Mailing Address - Fax:831-421-0954
Practice Address - Street 1:2320 E ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3630
Practice Address - Country:US
Practice Address - Phone:360-671-5736
Practice Address - Fax:360-733-2953
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12337171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist