Provider Demographics
NPI:1548320906
Name:KUDER ENTERPRISE
Entity type:Organization
Organization Name:KUDER ENTERPRISE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:PAULINE
Authorized Official - Last Name:KUDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-582-9205
Mailing Address - Street 1:PO BOX 418
Mailing Address - Street 2:
Mailing Address - City:BLACKHAWK
Mailing Address - State:CO
Mailing Address - Zip Code:80422
Mailing Address - Country:US
Mailing Address - Phone:303-582-9205
Mailing Address - Fax:303-582-9270
Practice Address - Street 1:135 CLEAR CREEK ST
Practice Address - Street 2:
Practice Address - City:BLACKHAWK
Practice Address - State:CO
Practice Address - Zip Code:80422
Practice Address - Country:US
Practice Address - Phone:303-582-9205
Practice Address - Fax:303-582-9270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty