Provider Demographics
NPI:1629741319
Name:KRIZEK, MATTHEW (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KRIZEK
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 1:4849 THOMPSON PKWY
Mailing Address - Street 2:STE B
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534
Mailing Address - Country:US
Mailing Address - Phone:719-822-4096
Mailing Address - Fax:
Practice Address - Street 1:4849 THOMPSON PKWY
Practice Address - Street 2:STE B
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534
Practice Address - Country:US
Practice Address - Phone:719-822-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008403111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor