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Frederick Persiko, M DIV., CACITI
NPI 1730320557 · on the registry since 2009
Practice
- Address
- 23400 Two Rivers Road
#49
Basalt, CO 81621 - Phone
- (970) 927-5357
- Fax
- (970) 927-3467
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 101YA0400X
- Licence states on file
- CO, MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2009-03-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado