Provider Demographics
NPI:1720600539
Name:BACKMAN, CARITA (CP,CF)
Entity Type:Individual
Prefix:
First Name:CARITA
Middle Name:
Last Name:BACKMAN
Suffix:
Gender:F
Credentials:CP,CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 SANTA FE DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-5025
Mailing Address - Country:US
Mailing Address - Phone:970-416-9357
Mailing Address - Fax:970-416-9359
Practice Address - Street 1:525 SANTA FE DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5025
Practice Address - Country:US
Practice Address - Phone:970-416-9357
Practice Address - Fax:970-416-9359
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000029761744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management