Healthcare Provider Details

I. General information

NPI: 1578737334
Provider Name (Legal Business Name): PSA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 05/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

547 S CORONA ST
DENVER CO
80209-4403
US

IV. Provider business mailing address

547 S CORONA ST
DENVER CO
80209-4403
US

V. Phone/Fax

Practice location:
  • Phone: 303-619-9625
  • Fax: 303-722-2101
Mailing address:
  • Phone: 303-619-9625
  • Fax: 303-722-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name: RHONDA M JUDGE
Title or Position: PRESIDENT
Credential: CST/CFA
Phone: 303-619-9625