Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CO002987 | CO |
NPI | 1649476045 |
---|---|
Provider Name | Mark Hassel |
First Address | Thornton, CO 80602-7208 |
Second Address | Denver, CO 80206-1514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2007 |
Last Update Date | 08/07/2007 |