Healthcare Provider Details

I. General information

NPI: 1710962295
Provider Name (Legal Business Name): DENVER EAR ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HAMPDEN AVE STE 415
ENGLEWOOD CO
80113-2759
US

IV. Provider business mailing address

701 E HAMPDEN AVE STE 415
ENGLEWOOD CO
80113-2759
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-7880
  • Fax: 303-788-7883
Mailing address:
  • Phone: 303-788-7880
  • Fax: 303-788-7883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE WALRATH
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 303-788-7880