Organization
DENHAM ORTHOTICS AND FITNESS
Active
Other names
Evolve Prosthetics and Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KOVACH CP,BOCO (PRESIDENT)
(702) 898-6000
Entity
Organization
Contact information
Practice address
601 WHITNEY RANCH DR, #C-17, HENDERSON, NV 89014-2642
(702) 898-6000
(702) 898-6080
Mailing address
601 WHITNEY RANCH DR, #C-17, HENDERSON, NV 89014-2642
(702) 898-6000
(702) 898-6080
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
CO003963
DE
224P00000X
Prosthetist
CP003298
DE
335E00000X
Prosthetic/Orthotic Supplier
Primary
C15202
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003302256
—
NV
01
—
4385780001
PTAN
NV
Enumeration date
04/20/2006
Last updated
01/03/2021
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