Provider Demographics
NPI:1952699225
Name:CZERNIAK, STEPHEN (DPT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:CZERNIAK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 HALE PKWY STE 550
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4053
Mailing Address - Country:US
Mailing Address - Phone:303-321-6600
Mailing Address - Fax:303-321-8814
Practice Address - Street 1:4700 HALE PKWY STE 550
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-321-6600
Practice Address - Fax:303-321-8814
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-018565225100000X
COPTL.0015699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist