Healthcare Provider Details

I. General information

NPI: 1841859212
Provider Name (Legal Business Name): JASON PAUL GRIFFIN C-PED, BOCO, CPA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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