Healthcare Provider Details

I. General information

NPI: 1285121913
Provider Name (Legal Business Name): DENNIS LUSE CP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 E. EXPOSITION AVE. SUITE #102
DENVER CO
80209
US

IV. Provider business mailing address

3955 E EXPOSITION AVE STE 102
DENVER CO
80209-5031
US

V. Phone/Fax

Practice location:
  • Phone: 303-722-0751
  • Fax: 303-722-4054
Mailing address:
  • Phone: 303-722-0751
  • Fax: 303-722-4054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: