Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 6873 | CO |
NPI | 1003177015 |
---|---|
Provider Name | Dr. Michelle Marie Wozniak |
First Address | Parker, CO 80134 |
Second Address | Parker, CO 80134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2012 |
Last Update Date | 06/06/2012 |