Lori Ptak

NPI #1508372152 in Divide, Colorado

Provider Information

NPI Number: 1508372152
Entity Type: Individual
Name: Lori Ptak
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Enumeration Date: Dec 19, 2017
Last Updated: Mar 17, 2018

Practice Location

Address: 11115 W HIGHWAY 24
Address 2: UNIT 2C
City: Divide
State: Colorado
ZIP Code: 80814
Phone: (719) 687-6416

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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