Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 1611 | NE |
Y | 111NN1001X | Nutrition | 6497 | CO |
NPI | 1265758130 |
---|---|
Provider Name | Dr. Lauren Marie Kolowski |
First Address | Loveland, CO 80538-4292 |
Second Address | Loveland, CO 80538-4292 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2010 |
Last Update Date | 16/04/2010 |