Provider Demographics
NPI:1790853737
Name:HASSE, RONALD DEAN (PT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DEAN
Last Name:HASSE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S CHERRY ST STE 640
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1233
Mailing Address - Country:US
Mailing Address - Phone:303-333-3493
Mailing Address - Fax:303-333-1184
Practice Address - Street 1:425 S CHERRY ST STE 640
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1233
Practice Address - Country:US
Practice Address - Phone:303-333-3493
Practice Address - Fax:303-333-1184
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO500438Medicare PIN