Organization
DENHAM ORTHOTICS AND FITNESS
Active
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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