Healthcare Provider Details

I. General information

NPI: 1407126097
Provider Name (Legal Business Name): CREST ASSISTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 S WASHINGTON ST
DENVER CO
80209-4307
US

IV. Provider business mailing address

PO BOX 663
ENGLEWOOD CO
80151-0663
US

V. Phone/Fax

Practice location:
  • Phone: 281-462-1285
  • Fax: 281-462-1554
Mailing address:
  • Phone: 281-462-1285
  • Fax: 281-462-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CREST
Title or Position: OWNER
Credential:
Phone: 281-462-1285