Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CPO04294 |
NPI | 1023780384 |
---|---|
Provider Name | Elise Griset |
First Address | Denver, CO 80202-2378 |
Second Address | Denver, CO 80202-2378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2021 |
Last Update Date | 05/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CPO04294 | CPO CERTIFICATION (01) |