Healthcare Provider Details

I. General information

NPI: 1740695105
Provider Name (Legal Business Name): HOLLY ELIZABETH CAUTHRON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 09/10/2022
Certification Date: 09/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 W 38TH AVE
DENVER CO
80212-2025
US

IV. Provider business mailing address

4901 W 38TH AVE
DENVER CO
80212-2025
US

V. Phone/Fax

Practice location:
  • Phone: 303-781-7862
  • Fax: 303-781-7864
Mailing address:
  • Phone: 303-781-7862
  • Fax: 303-781-7864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberDR.0061185
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: