Provider Demographics
NPI:1245413962
Name:LASZLO, KEPPEN LOUIS (DC)
Entity Type:Individual
Prefix:DR
First Name:KEPPEN
Middle Name:LOUIS
Last Name:LASZLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7535 W 92ND AVE
Mailing Address - Street 2:#600
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-5612
Mailing Address - Country:US
Mailing Address - Phone:303-425-9557
Mailing Address - Fax:303-425-3399
Practice Address - Street 1:7535 W 92ND AVE
Practice Address - Street 2:#600
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-5612
Practice Address - Country:US
Practice Address - Phone:303-425-9557
Practice Address - Fax:303-425-3399
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLA631494OtherBLUE CROSS BLUE SHIELD
COLA631494OtherBLUE CROSS BLUE SHIELD
CO48313Medicare UPIN