Provider Demographics
NPI:1376715672
Name:HINES, GERALD JEROME (RRT)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:JEROME
Last Name:HINES
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25038 E CANAL PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80018-1705
Mailing Address - Country:US
Mailing Address - Phone:303-907-4754
Mailing Address - Fax:
Practice Address - Street 1:25038 E CANAL PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80018-1705
Practice Address - Country:US
Practice Address - Phone:303-907-4754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1844227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered