Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1285121913 |
---|---|
Provider Name | Mr. Dennis Luse |
First Address | Denver, CO 80209-5031 |
Second Address | Denver, CO 80209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2018 |
Last Update Date | 18/04/2018 |