Healthcare Provider Details

I. General information

NPI: 1871891390
Provider Name (Legal Business Name): MARK HORTON, CSA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 03/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7323 E BATES DR
DENVER CO
80231-6010
US

IV. Provider business mailing address

PO BOX 470715
AURORA CO
80047-0715
US

V. Phone/Fax

Practice location:
  • Phone: 303-249-5253
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK HORTON
Title or Position: OWNER
Credential: CSA
Phone: 303-249-5253