MEDICARE: ROCKY MOUNTAIN REHABILITATION SPECIALIST LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	29548	CO

General Provider Information

NPI Number	:	1184846966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKY MOUNTAIN REHABILITATION SPECIALIST LLC

Provider Business Mailing Address
First Line	:	1380 S SANTA FE DR
Second Line	:	STE. 100
City	:	DENVER
State	:	CO
Zip	:	80223-3260
Country	:	US
Telephone Number	:	303-777-3422
Fax Number	:	303-777-3425

Provider Business Practice Location Address
First Line	:	1380 S SANTA FE DR
Second Line	:	STE. 100
City	:	DENVER
State	:	CO
Zip	:	80223-3260
Country	:	US
Telephone Number	:	303-777-3422
Fax Number	:	303-777-3425

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RACHEL LEE BASSE
Credential	:	M.D.
Telephone Number	:	303-777-3422

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	08/22/2020

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