Provider Demographics
NPI:1235303363
Name:VERHOEVEN, ERWIN J C (OTR)
Entity Type:Individual
Prefix:
First Name:ERWIN
Middle Name:J C
Last Name:VERHOEVEN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 W MOORHEAD CIR APT 2J
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6131
Mailing Address - Country:US
Mailing Address - Phone:303-554-0849
Mailing Address - Fax:
Practice Address - Street 1:860 W MOORHEAD CIR APT 2J
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6131
Practice Address - Country:US
Practice Address - Phone:303-554-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AA535849225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist