Healthcare Provider Details

I. General information

NPI: 1144238569
Provider Name (Legal Business Name): CYNTHIA S CLASSEN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA S OBERHOLTZER DPM

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 VILLAGE SQUARE DR SUITE 101
CASTLE PINES CO
80108-3692
US

IV. Provider business mailing address

7505 VILLAGE SQUARE DR SUITE 101
CASTLE PINES CO
80108-3692
US

V. Phone/Fax

Practice location:
  • Phone: 303-805-5156
  • Fax: 303-805-5157
Mailing address:
  • Phone: 303-805-5156
  • Fax: 303-805-5157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number490
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: