Healthcare Provider Details

I. General information

NPI: 1497085377
Provider Name (Legal Business Name): PRECISE SURGICAL OF DENVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2009
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 E 19TH AVE
DENVER CO
80218-1235
US

IV. Provider business mailing address

1940 S LANSING CT
AURORA CO
80014-1056
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-6000
  • Fax:
Mailing address:
  • Phone: 720-201-3690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number09264
License Number StateCO

VIII. Authorized Official

Name: MR. ROMAN BACHAYEV
Title or Position: SA-C
Credential:
Phone: 720-201-3690