Individual
ELLEN MARIE HAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12635 CANOE ST, FIRESTONE, CO 80504-5324
(720) 253-3608
Mailing address
12635 CANOE ST, FIRESTONE, CO 80504-5324
(720) 253-3608
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
COS.0041657
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20211612269
LLC REGISTRATION
CO
Enumeration date
10/25/2021
Last updated
10/25/2021
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