Healthcare Provider Details
I. General information
NPI: 1376348722
Provider Name (Legal Business Name): ASE MEDICAL CO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23750 E 14TH AVE STE 300
AURORA CO
80018-1974
US
IV. Provider business mailing address
23750 E 14TH AVE STE 300
AURORA CO
80018-1974
US
V. Phone/Fax
- Phone: 720-830-4199
- Fax:
- Phone: 720-830-4199
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AKE
EVANS
Title or Position: OWNER
Credential: MD
Phone: 720-830-4199