Provider Demographics
NPI:1679840318
Name:TRZASKA, STEPHANIE (LAC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:TRZASKA
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 1:11658 HURON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2919
Mailing Address - Country:US
Mailing Address - Phone:303-362-0596
Mailing Address - Fax:
Practice Address - Street 1:11658 HURON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-2919
Practice Address - Country:US
Practice Address - Phone:303-362-0596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1732171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist