Provider Demographics
NPI:1134183882
Name:CYGAN, JOSEPH WILLIAM JR (MS, ATC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:CYGAN
Suffix:JR
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 W MEADOW DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81657-5242
Mailing Address - Country:US
Mailing Address - Phone:970-343-9217
Mailing Address - Fax:
Practice Address - Street 1:181 W MEADOW DR
Practice Address - Street 2:SUITE 400
Practice Address - City:VAIL
Practice Address - State:CO
Practice Address - Zip Code:81657-5242
Practice Address - Country:US
Practice Address - Phone:970-343-9217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001275-12255A2300X
CO5602255A2300X
0801020972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer