Provider Demographics
NPI:1124333786
Name:HUDAK, STEVEN (MPT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:HUDAK
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-2261
Mailing Address - Country:US
Mailing Address - Phone:303-289-7110
Mailing Address - Fax:
Practice Address - Street 1:78-6957 KAMEHAMEHA III RD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2528
Practice Address - Country:US
Practice Address - Phone:808-322-2790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2578225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist