Provider Demographics
NPI:1255041802
Name:THOMPSON, GLEN C (CPO)
Entity type:Individual
Prefix:
First Name:GLEN
Middle Name:C
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 E FLORIDA AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3620
Mailing Address - Country:US
Mailing Address - Phone:303-722-0751
Mailing Address - Fax:
Practice Address - Street 1:4105 E FLORIDA AVE STE 301
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3620
Practice Address - Country:US
Practice Address - Phone:303-722-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist