Healthcare Provider Details

I. General information

NPI: 1730929167
Provider Name (Legal Business Name): MRS. ELLEN FILONOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 S ONEIDA ST STE 280
DENVER CO
80224-2466
US

IV. Provider business mailing address

2569 S KENDRICK ST
LAKEWOOD CO
80228-5540
US

V. Phone/Fax

Practice location:
  • Phone: 303-524-4106
  • Fax:
Mailing address:
  • Phone: 303-524-4106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number0026199
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: