Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | LO46 | OK |
Y | 222Z00000X | Podiatrist | LO46 | OK |
N | 224P00000X | Prosthetist | LP29 | OK |
NPI | 1275770810 |
---|---|
Provider Name | Kyle A Sherk |
First Address | Denver, CO 80218-3666 |
Second Address | Denver, CO 80218-3666 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2009 |
Last Update Date | 05/10/2015 |