Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | CO |
NPI | 1003577933 |
---|---|
Provider Name | Kindra B Marko |
First Address | Lone Tree, CO 80124-5425 |
Second Address | Lakewood, CO 80226-3099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2022 |
Last Update Date | 03/01/2022 |