Provider Demographics
NPI:1659419612
Name:DECKER, DAVID (RT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DECKER
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 E GEDDES AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3861
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:303-761-6278
Practice Address - Street 1:7700 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2602
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:303-761-6322
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
339195OtherARRT CERTIFICATION