Provider Demographics
NPI:1821441585
Name:K&T CLEAN UP
Entity Type:Organization
Organization Name:K&T CLEAN UP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SELDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-424-3184
Mailing Address - Street 1:340 S ASH ST
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-3018
Mailing Address - Country:US
Mailing Address - Phone:970-424-3184
Mailing Address - Fax:
Practice Address - Street 1:340 S ASH ST
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-3018
Practice Address - Country:US
Practice Address - Phone:970-424-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty