Healthcare Provider Details

I. General information

NPI: 1164695672
Provider Name (Legal Business Name): CREATIVE TECHNOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 02/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 S COLORADO BLVD SUITE 100
DENVER CO
80222-5946
US

IV. Provider business mailing address

2425 SOUTH COLORADO BLVD. SUITE 100
DENVER CO
80222-5937
US

V. Phone/Fax

Practice location:
  • Phone: 303-346-1906
  • Fax: 303-962-1820
Mailing address:
  • Phone: 303-346-1906
  • Fax: 303-962-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateCO

VIII. Authorized Official

Name: JASON MUSGRAVE
Title or Position: CEO
Credential:
Phone: 303-346-1906