Provider Demographics
NPI:1912331802
Name:DISCOVER HEALTH AND WELLNESS KEN CARYL, LLC
Entity Type:Organization
Organization Name:DISCOVER HEALTH AND WELLNESS KEN CARYL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEPPEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LASZLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-425-9557
Mailing Address - Street 1:8081 SHAFFER PKWY
Mailing Address - Street 2:STE. B-3
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8081 SHAFFER PKWY
Practice Address - Street 2:STE. B-3
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3713
Practice Address - Country:US
Practice Address - Phone:303-425-9557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty