Healthcare Provider Details
I. General information
NPI: 1033414446
Provider Name (Legal Business Name): CREATIVE TECHNOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/14/2011
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8300 ALCOTT ST SUITE 105
WESTMINSTER CO
80031-4008
US
IV. Provider business mailing address
2425 S COLORADO BLVD SUITE 100
DENVER CO
80222-5946
US
V. Phone/Fax
- Phone: 303-346-1906
- Fax: 303-962-1820
- Phone: 303-346-1906
- Fax: 303-962-1820
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JASON
MUSGRAVE
Title or Position: OFFICER
Credential:
Phone: 303-346-1906