Healthcare Provider Details

I. General information

NPI: 1891017190
Provider Name (Legal Business Name): ARDEN MAHAFFEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2010
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2695 ROCKY MOUNTAIN AVE SUITE 200
LOVELAND CO
80538-8702
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE SUITE 200
LOVELAND CO
80538-8702
US

V. Phone/Fax

Practice location:
  • Phone: 970-482-4373
  • Fax: 970-484-5682
Mailing address:
  • Phone: 970-482-4373
  • Fax: 970-484-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number34009705
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberDR.0052992
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: