Provider Demographics
NPI:1629413778
Name:AEGIS PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:AEGIS PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CULBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:303-351-7060
Mailing Address - Street 1:5460 WARD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1800
Mailing Address - Country:US
Mailing Address - Phone:303-351-7060
Mailing Address - Fax:303-395-0826
Practice Address - Street 1:5460 WARD RD STE 300
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1800
Practice Address - Country:US
Practice Address - Phone:303-351-7060
Practice Address - Fax:303-395-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40322246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty