Healthcare Provider Details

I. General information

NPI: 1609218734
Provider Name (Legal Business Name): JARROD KEEVER CST/CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 03/12/2022
Certification Date: 03/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12584 E BATES CIR
AURORA CO
80014-3314
US

IV. Provider business mailing address

3024 S FAIRFAX ST
DENVER CO
80222-7346
US

V. Phone/Fax

Practice location:
  • Phone: 303-901-5880
  • Fax:
Mailing address:
  • Phone: 303-901-5880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number1127
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: