Healthcare Provider Details

I. General information

NPI: 1962685842
Provider Name (Legal Business Name): ASCENT ORTHOTICS AND PROSTHETICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 FILLMORE ST GL5
DENVER CO
80206-1514
US

IV. Provider business mailing address

1633 FILLMORE ST GL5
DENVER CO
80206-1514
US

V. Phone/Fax

Practice location:
  • Phone: 303-316-2615
  • Fax:
Mailing address:
  • Phone: 303-316-2615
  • Fax:

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: PAUL N HENDRICKSON
Title or Position: PRESIDENT
Credential: CP
Phone: 303-316-2615