Healthcare Provider Details

I. General information

NPI: 1033940598
Provider Name (Legal Business Name): PURE CRANIAL CREATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4892 DEARBORN ST
DENVER CO
80239-6410
US

IV. Provider business mailing address

27431 E 6TH DR
AURORA CO
80018-1852
US

V. Phone/Fax

Practice location:
  • Phone: 720-936-1571
  • Fax:
Mailing address:
  • Phone: 720-936-1571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: PATIENCE ELKINS
Title or Position: CEO
Credential:
Phone: 720-936-1571