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General NPI Number Information
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NPI Number | 1346712924
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Entity Type | Individual
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Provider Name | NICHOLAS CRITCHFIELD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 9000 E NICHOLS AVE STE 104
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City | CENTENNIAL
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State | CO
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Zip | 80112-3429
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Country | US
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Telephone | 684-984-4274
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Fax |
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Provider Business Mailing Address
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Address Line | 2938 W BATH RD
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City | AKRON
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State | OH
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Zip | 44333-2038
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Country | US
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Telephone | 330-612-0736
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT005215
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License Number State | OH
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