Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 35-096937 | OH |
Y | 207QS0010X | Family Doctor - Sports Medicine | DR.0065137 | CO |
NPI | 1104071588 |
---|---|
Provider Name | Ms. Sylvia Joanna Rozek |
First Address | Hilliard, OH 43026 |
Second Address | Durango, CO 81301-7307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2008 |
Last Update Date | 02/02/2021 |