Provider Demographics
NPI:1912950395
Name:KUZMA, SALINDA ANNE (LPT)
Entity Type:Individual
Prefix:MRS
First Name:SALINDA
Middle Name:ANNE
Last Name:KUZMA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20370 LOCKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2332
Mailing Address - Country:US
Mailing Address - Phone:719-531-5317
Mailing Address - Fax:719-531-5317
Practice Address - Street 1:20370 LOCKRIDGE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-2332
Practice Address - Country:US
Practice Address - Phone:719-531-5317
Practice Address - Fax:719-531-5317
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2082174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38358034Medicaid