Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1101X | Ophthalmic Assistant | CO |
NPI | 1750588455 |
---|---|
Provider Name | Mr. Donald James Kubec |
First Address | Highlands Ranch, CO 80129-2262 |
Second Address | Highlands Ranch, CO 80129-2262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 08/07/2007 |