Provider Demographics
NPI:1508004938
Name:ONDRAKO, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ONDRAKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 SOUTH SPRUCE STREET, STE 125
Mailing Address - Street 2:SODEXO WELLNESS AND NUTRITION SERVICES
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:303-779-9355
Mailing Address - Fax:303-779-0956
Practice Address - Street 1:6767 SOUTH SPRUCE STREET, STE 125
Practice Address - Street 2:SODEXO WELLNESS AND NUTRITION SERVICES
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:303-779-9355
Practice Address - Fax:303-779-0956
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered