Most Relevant Information
Provider Data
| NPI Number: | 1003015801 |
| Provider Name: | STAS' TRAKUL |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 19960 |
Most Important Dates
| Enumeration Date: | 07/12/2007 |
| Last Updated: | 07/12/2007 |
Provider Practice Location
8383 W ALAMEDA AVE
LAKEWOOD
CO
802263007
Practice Location Phone/Fax
| Phone: | 3032397340 |
| Fax: |
Provider Mailing Location
8383 W ALAMEDA AVE
LAKEWOOD
CO
802263007
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |