Provider Demographics
NPI:1447748496
Name:PLASTIC & RECONSTRUCTIVE INSTITUTE OF DENVER, LLC
Entity Type:Organization
Organization Name:PLASTIC & RECONSTRUCTIVE INSTITUTE OF DENVER, LLC
Other - Org Name:PLASTIC & RECONSTRUCTIVE INSTITUTE OF DENVER, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZUHLKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-215-0700
Mailing Address - Street 1:16677 LOWELL BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8053
Mailing Address - Country:US
Mailing Address - Phone:720-215-0700
Mailing Address - Fax:877-332-3131
Practice Address - Street 1:16677 LOWELL BLVD STE 210
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-8053
Practice Address - Country:US
Practice Address - Phone:720-215-0700
Practice Address - Fax:877-332-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty