Provider Demographics
NPI:1245689801
Name:RESEK, AUSTYN FRANCES (MS, ATC, CES, NREMT)
Entity type:Individual
Prefix:
First Name:AUSTYN
Middle Name:FRANCES
Last Name:RESEK
Suffix:
Gender:F
Credentials:MS, ATC, CES, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MOUNT TRAVER DR
Mailing Address - Street 2:
Mailing Address - City:LEADVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80461-3463
Mailing Address - Country:US
Mailing Address - Phone:802-451-8052
Mailing Address - Fax:
Practice Address - Street 1:104 MOUNT TRAVER DR
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3463
Practice Address - Country:US
Practice Address - Phone:802-451-8052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00012342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer